Hanchard B
Department of Pathology, University of the West Indies, Kingston, Jamaica.
J Acquir Immune Defic Syndr Hum Retrovirol. 1996;13 Suppl 1:S20-5. doi: 10.1097/00042560-199600001-00005.
Adult T-cell leukemia/lymphoma (ATL) is the commonest lymphoid malignancy in adult Jamaicans, reflecting the role of the causative agent, human T-cell lymphotrophic virus type I (HTLV-I), in altering the pattern of non-Hodgkin lymphoma in an endemic area. A total of 126 cases of ATL were registered in Jamaica between January 1985 and July 1995. There were 65 male and 61 female patients (male-female ratio, 1:1), with a mean age of 43 years (17-85 years). The majority of cases were acute subtype (46.8%), followed by lymphoma (27%), chronic (20.6%), and smoldering (5.6%) types. The disease is associated with a high mortality, with only five of the 126 patients currently alive. The median survival rate is 20 weeks. The epidemiologic, clinical, and laboratory features are similar to those reported in Japan and Brazil, except that the mean age of patients, identical in Jamaica and Brazil (43 years), is 11 years younger than that in Japan (54 years). Given the theory that ATL develops after a long incubation period after early life exposure to HTLV-I facilitated by mother-to-child transmission via breast milk, and the fact that mothers of ATL patients have a high incidence of HTLV-I seropositivity, it would appear that reduction in the incidence of this disease could be achieved by methods aimed at preventing this mode of transmission.
成人T细胞白血病/淋巴瘤（ATL）是牙买加成年人中最常见的淋巴恶性肿瘤，这反映了致病因子——人类T细胞白血病病毒I型（HTLV-I）在改变地方性流行区非霍奇金淋巴瘤模式方面所起的作用。1985年1月至1995年7月期间，牙买加共登记了126例ATL病例。有65例男性和61例女性患者（男女比例为1:1），平均年龄为43岁（17 - 85岁）。大多数病例为急性亚型（46.8%），其次是淋巴瘤型（27%）、慢性型（20.6%）和隐匿型（5.6%）。该疾病死亡率很高，126例患者中目前仅有5人存活。中位生存期为20周。其流行病学、临床和实验室特征与日本和巴西报道的相似，只是牙买加和巴西患者的平均年龄相同（43岁），比日本患者的平均年龄（54岁）小11岁。鉴于ATL是在早年通过母乳母婴传播感染HTLV-I后经过很长潜伏期才发病这一理论，以及ATL患者的母亲HTLV-I血清阳性率很高这一事实，似乎可以通过旨在预防这种传播方式的方法来降低该疾病的发病率。
