Infectious complications and immunodeficiency in patients with human T‐cell lymphotropic virus I‐associated adult T‐cell leukemia/lymphoma

Jeffrey D. White, Sara L. Zaknoen, Claude Sportes, Lois E. Top, Lydia Navarro‐Roman, David L. Nelson, Thomas A. Waldmann

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Background. Adult T‐cell leukemia/lymphoma (ATL) is a malignancy of mature T‐cells occurring in patients infected with the human T‐cell lymphotropic virus‐I. These patients frequently develop a variety of infections throughout their disease course. Methods. Charts and autopsy reports were reviewed for 41 patients with ATL with follow‐up varying from 2 to 120 months. Infectious episodes were identified and documented. Analyses of humoral and cell‐mediated immunity were performed. Cell‐mediated immunity was assessed in vivo with the Merieux multitest skin test panel. Humoral immunity was assessed by quantitative immunoglobulin levels, by determining human antimouse antibody after murine monoclonal antibody infusion and by an in vitro immunoglobulin biosynthesis coculture system. Results. A total of 112 infectious episodes were documented. Fifty‐seven serious infections were identified. The incidence of total infections was 1.40/patien‐year and for serious infections was 0.71/patient‐year. The mean serum IgG and IgA levels were within normal range, the mean IgM level was at the lower limit of normal. Peripheral blood mononuclear cells from all patients studied failed to make meaningful amounts of IgG, M, or A when activated. Peripheral blood mononuclear cells of all of the 13 patients studied suppressed production immunoglobulin by cocultured normal PBMC. Twenty‐three of the 27 patients tested were anergic. Conclusions. ATL is a profoundly immunosuppressing malignancy. This is manifested by an extremel incidence of infectious episodes/patient‐year. The incidence of infection appears to be greater than for mycosis fungoides, Hodgkin's lymphoma and non‐Hodgkin's lymphoma. Cancer 1995;75:1598‐607.

Original languageEnglish (US)
Pages (from-to)1598-1607
Number of pages10
JournalCancer
Volume75
Issue number7
DOIs
StatePublished - Apr 1 1995
Externally publishedYes

Fingerprint

Lymphoma
Leukemia
Viruses
Immunoglobulins
Infection
Humoral Immunity
Blood Cells
Incidence
Immunoglobulin G
Neoplasms
Mycosis Fungoides
Coculture Techniques
Skin Tests
Hodgkin Disease
Non-Hodgkin's Lymphoma
Immunoglobulin A
Immunoglobulin M
Autopsy
Immunity
Reference Values

Keywords

  • T cell
  • antibodies
  • immunocompromised host human T‐cell lymphotropic virus type I (HTLV‐I) infections
  • interleukin‐2
  • leukemia
  • monoclonal
  • receptors

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Infectious complications and immunodeficiency in patients with human T‐cell lymphotropic virus I‐associated adult T‐cell leukemia/lymphoma. / White, Jeffrey D.; Zaknoen, Sara L.; Sportes, Claude; Top, Lois E.; Navarro‐Roman, Lydia; Nelson, David L.; Waldmann, Thomas A.

In: Cancer, Vol. 75, No. 7, 01.04.1995, p. 1598-1607.

Research output: Contribution to journalArticle

White, Jeffrey D. ; Zaknoen, Sara L. ; Sportes, Claude ; Top, Lois E. ; Navarro‐Roman, Lydia ; Nelson, David L. ; Waldmann, Thomas A. / Infectious complications and immunodeficiency in patients with human T‐cell lymphotropic virus I‐associated adult T‐cell leukemia/lymphoma. In: Cancer. 1995 ; Vol. 75, No. 7. pp. 1598-1607.
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abstract = "Background. Adult T‐cell leukemia/lymphoma (ATL) is a malignancy of mature T‐cells occurring in patients infected with the human T‐cell lymphotropic virus‐I. These patients frequently develop a variety of infections throughout their disease course. Methods. Charts and autopsy reports were reviewed for 41 patients with ATL with follow‐up varying from 2 to 120 months. Infectious episodes were identified and documented. Analyses of humoral and cell‐mediated immunity were performed. Cell‐mediated immunity was assessed in vivo with the Merieux multitest skin test panel. Humoral immunity was assessed by quantitative immunoglobulin levels, by determining human antimouse antibody after murine monoclonal antibody infusion and by an in vitro immunoglobulin biosynthesis coculture system. Results. A total of 112 infectious episodes were documented. Fifty‐seven serious infections were identified. The incidence of total infections was 1.40/patien‐year and for serious infections was 0.71/patient‐year. The mean serum IgG and IgA levels were within normal range, the mean IgM level was at the lower limit of normal. Peripheral blood mononuclear cells from all patients studied failed to make meaningful amounts of IgG, M, or A when activated. Peripheral blood mononuclear cells of all of the 13 patients studied suppressed production immunoglobulin by cocultured normal PBMC. Twenty‐three of the 27 patients tested were anergic. Conclusions. ATL is a profoundly immunosuppressing malignancy. This is manifested by an extremel incidence of infectious episodes/patient‐year. The incidence of infection appears to be greater than for mycosis fungoides, Hodgkin's lymphoma and non‐Hodgkin's lymphoma. Cancer 1995;75:1598‐607.",
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T1 - Infectious complications and immunodeficiency in patients with human T‐cell lymphotropic virus I‐associated adult T‐cell leukemia/lymphoma

AU - White, Jeffrey D.

AU - Zaknoen, Sara L.

AU - Sportes, Claude

AU - Top, Lois E.

AU - Navarro‐Roman, Lydia

AU - Nelson, David L.

AU - Waldmann, Thomas A.

PY - 1995/4/1

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N2 - Background. Adult T‐cell leukemia/lymphoma (ATL) is a malignancy of mature T‐cells occurring in patients infected with the human T‐cell lymphotropic virus‐I. These patients frequently develop a variety of infections throughout their disease course. Methods. Charts and autopsy reports were reviewed for 41 patients with ATL with follow‐up varying from 2 to 120 months. Infectious episodes were identified and documented. Analyses of humoral and cell‐mediated immunity were performed. Cell‐mediated immunity was assessed in vivo with the Merieux multitest skin test panel. Humoral immunity was assessed by quantitative immunoglobulin levels, by determining human antimouse antibody after murine monoclonal antibody infusion and by an in vitro immunoglobulin biosynthesis coculture system. Results. A total of 112 infectious episodes were documented. Fifty‐seven serious infections were identified. The incidence of total infections was 1.40/patien‐year and for serious infections was 0.71/patient‐year. The mean serum IgG and IgA levels were within normal range, the mean IgM level was at the lower limit of normal. Peripheral blood mononuclear cells from all patients studied failed to make meaningful amounts of IgG, M, or A when activated. Peripheral blood mononuclear cells of all of the 13 patients studied suppressed production immunoglobulin by cocultured normal PBMC. Twenty‐three of the 27 patients tested were anergic. Conclusions. ATL is a profoundly immunosuppressing malignancy. This is manifested by an extremel incidence of infectious episodes/patient‐year. The incidence of infection appears to be greater than for mycosis fungoides, Hodgkin's lymphoma and non‐Hodgkin's lymphoma. Cancer 1995;75:1598‐607.

AB - Background. Adult T‐cell leukemia/lymphoma (ATL) is a malignancy of mature T‐cells occurring in patients infected with the human T‐cell lymphotropic virus‐I. These patients frequently develop a variety of infections throughout their disease course. Methods. Charts and autopsy reports were reviewed for 41 patients with ATL with follow‐up varying from 2 to 120 months. Infectious episodes were identified and documented. Analyses of humoral and cell‐mediated immunity were performed. Cell‐mediated immunity was assessed in vivo with the Merieux multitest skin test panel. Humoral immunity was assessed by quantitative immunoglobulin levels, by determining human antimouse antibody after murine monoclonal antibody infusion and by an in vitro immunoglobulin biosynthesis coculture system. Results. A total of 112 infectious episodes were documented. Fifty‐seven serious infections were identified. The incidence of total infections was 1.40/patien‐year and for serious infections was 0.71/patient‐year. The mean serum IgG and IgA levels were within normal range, the mean IgM level was at the lower limit of normal. Peripheral blood mononuclear cells from all patients studied failed to make meaningful amounts of IgG, M, or A when activated. Peripheral blood mononuclear cells of all of the 13 patients studied suppressed production immunoglobulin by cocultured normal PBMC. Twenty‐three of the 27 patients tested were anergic. Conclusions. ATL is a profoundly immunosuppressing malignancy. This is manifested by an extremel incidence of infectious episodes/patient‐year. The incidence of infection appears to be greater than for mycosis fungoides, Hodgkin's lymphoma and non‐Hodgkin's lymphoma. Cancer 1995;75:1598‐607.

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KW - antibodies

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KW - leukemia

KW - monoclonal

KW - receptors

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