Darryl Shibata, MD; Russell K. Brynes, MD; Arthur Rabinowitz, MD; Curtis A. Hanson, MD; Marilyn L. Slovak, PhD; Thomas J. Spira, MD; Parkash Gill, MD
A patient had adult T-cell leukemia-lymphoma in the unusual setting of coinfection with human immunodeficiency virus type 1 (HIV-1) and human T-cell lymphotropic virus type I (HTLV-1). The leukemic cells were CD4 positive and showed clonal genetic rearrangement of the T-cell receptor complex. Cytogenetic analysis showed three clonal karyotypic abnormalities: trisomy 3 and two translocations [t(1;15), (X;1)]. The patient was seropositive for HIV and HTLV-I; HTLV-I and HIV-1 DNA sequences were detected in peripheral blood leukocytes by the polymerase chain reaction. The HTLV-I sequences were detected in a relatively high proportion of mononuclear cells (at least 1 in 30 cells), whereas HIV-1 sequences were detected in a smaller proportion of cells (at least 1 in 3000 cells). Clinical remission was achieved after chemotherapy. There was a decrease in the proportion of HTLV-I positive mononuclear cells (at least 1 in 1000 cells), whereas the proportion of HIV-1 positive cells was relatively unchanged (at least 1 in 1000 cells). Adult T-cell leukemia-lymphoma in the setting of HIV coinfection may become increasingly common because asymptomatic retroviral coinfections are frequent.
Shibata D, Brynes RK, Rabinowitz A, Hanson CA, Slovak ML, Spira TJ, et al. Human T-Cell Lymphotropic Virus Type I (HTLV-I)-Associated Adult T-Cell Leukemia-Lymphoma in a Patient Infected with Human Immunodeficiency Virus Type 1 (HIV-1). Ann Intern Med. ;111:871–875. doi: 10.7326/0003-4819-111-11-871
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Published: Ann Intern Med. 1989;111(11):871-875.
Hematology/Oncology, HIV, Infectious Disease, Leukemia/Lymphoma.
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