Welles S L, Levine P H, Joseph E M, Goberdhan L J, Lee S, Miotti A, Cervantes J, Bertoni M, Jaffe E, Dosik H
Department of Biostatistics, Harvard School of Public Health, Boston, MA.
Leukemia. 1994 Apr;8 Suppl 1:S111-5.
The Brooklyn Adult T-cell Leukemia/Lymphoma (ATL) study was developed to estimate the incidence of the human T-cell lymphotropic virus type I (HTLV-I)-associated ATL in the Crown Heights/Bedford Stuyvesant community. This central Brooklyn black community is an area which has already been shown in earlier reports to be endemic for HTLV-I-associated ATL. Surveillance has been conducted at seven area hospitals that serve this community, with surveillance already completed at five hospitals. Potential study subjects who are 20 years or older are identified by the review of admission records, discharge summaries, pathology and clinical chemistry reports, or physician referrals. Diagnoses of leukemia or lymphoma, or the presence of leukocytosis or hypercalcemia are used as criteria to identify the subjects. Participating subjects give a sample of blood for the determination of HTLV-I infection by serologic tests. At the time of enrollment, subjects provide demographic information including age, sex and birthplace. After one year of surveillance at five hospitals (39.5% of inpatient beds in the catchment), we have identified 12 cases of HTLV-I-associated ATL. The mean age of the ATL patients was 50 years, with patients being predominantly female (83.3%) and often Caribbean immigrants (83.3%). Interestingly, 42% of our cases were identified solely by findings of hypercalcemia from clinical chemistry reports. The remaining ATL cases were identified by physician referral. This enhanced surveillance program that uses both clinical and laboratory criteria for ATL case ascertainment can serve as a prototype for similar surveillance in other areas endemic for HTLV-I-associated ATL--an important effort because of the strong potential for disease prevention.
布鲁克林成人T细胞白血病/淋巴瘤（ATL）研究旨在估算克朗高地/贝德福德-斯图维桑特社区中与人类T细胞嗜淋巴细胞病毒I型（HTLV-I）相关的ATL发病率。布鲁克林中部的这个黑人社区是一个在早期报告中已被证明为HTLV-I相关ATL流行地区。已对为该社区服务的七家地区医院进行了监测，其中五家医院的监测已经完成。通过审查入院记录、出院小结、病理和临床化学报告或医生转诊来确定年龄在20岁及以上的潜在研究对象。白血病或淋巴瘤的诊断，或白细胞增多或高钙血症的存在被用作确定研究对象的标准。参与研究的对象提供一份血液样本，通过血清学检测来确定HTLV-I感染情况。在入组时，研究对象提供包括年龄、性别和出生地在内的人口统计学信息。在五家医院进行了一年的监测（覆盖集水区39.5%的住院床位）后，我们已确定了12例与HTLV-I相关的ATL病例。ATL患者的平均年龄为50岁，患者以女性为主（83.3%），且多为加勒比移民（83.3%）。有趣的是，我们42%的病例仅通过临床化学报告中的高钙血症发现得以确定。其余的ATL病例是通过医生转诊确定的。这个强化监测项目使用临床和实验室标准来确定ATL病例，可作为在其他HTLV-I相关ATL流行地区进行类似监测的范例——鉴于疾病预防的巨大潜力，这是一项重要工作。
