Ramassamy Jill-Léa, Tortevoye Patricia, Ntab Balthazar, Seve Béatrice, Carles Gabriel, Gaquière Dominique, Madec Yoann, Fontanet Arnaud, Gessain Antoine
Institut Pasteur, Unité d'Epidémiologie et Physiopathologie des Virus Oncogènes, Département de Virologie, Unité Mixte de Recherche 3569, Centre National de la Recherche Scientifique, Paris, France.
Université de Paris, Paris, France.
Blood Adv. 2020 May 12;4(9):2044-2048. doi: 10.1182/bloodadvances.2020001628.
Adult T-cell leukemia/lymphoma (ATL) is an aggressive malignancy caused by the human T-cell leukemia virus type 1 (HTLV-1). The incidence of ATL among HTLV-1 carriers remains largely unknown in endemic countries other than Japan as very few prospective studies have been performed. We assessed the ATL incidence rate among HTLV-1 infected women in a prospective cohort in French Guiana. This is the first prospective study to assess the ATL incidence rate in an area of South America where HTLV-1 prevalence is high. Patients were enrolled between 1991 and 2005, and follow-up continued until April 2018. In the general hospital in Saint-Laurent-du-Maroni, 307 pregnant women were diagnosed with HTLV-1 infection, and 268 of them were observed for a median of 16.7 years. During follow-up, 9 ATL incident cases occurred resulting in an ATL incidence rate of 2.03 per 1000 HTLV-1 carrier-years (95% confidence interval, 0.93-3.85 per 1000 HTLV-1 carrier-years). The median age at diagnosis was 47.4 years, and median survival from diagnosis was low at 3.5 months. The ATL incidence rate was elevated for a study population consisting mostly of young people, which could either be a general feature in South America or could be specific to the Noir Marron population that constituted most of the cohort.
成人T细胞白血病/淋巴瘤（ATL）是一种由1型人类T细胞白血病病毒（HTLV-1）引起的侵袭性恶性肿瘤。在日本以外的流行国家，HTLV-1携带者中ATL的发病率在很大程度上仍不清楚，因为很少有前瞻性研究。我们在法属圭亚那的一个前瞻性队列中评估了HTLV-1感染女性的ATL发病率。这是第一项评估HTLV-1患病率高的南美地区ATL发病率的前瞻性研究。患者于1991年至2005年入组，随访持续至2018年4月。在圣洛朗-迪马罗尼的综合医院，307名孕妇被诊断为HTLV-1感染，其中268人被观察了16.7年的中位数。随访期间，发生了9例ATL发病病例，导致ATL发病率为每1000名HTLV-1携带者年2.03例（95%置信区间，每1000名HTLV-1携带者年0.93 - 3.85例）。诊断时的中位年龄为47.4岁，诊断后的中位生存期较低，为3.5个月。对于主要由年轻人组成的研究人群，ATL发病率有所升高，这可能是南美的普遍特征，也可能是构成该队列大多数的黑棕色人种所特有的。
