Adult T cell leukaemia/lymphoma in Kerala, South India: are we staring at the tip of the iceberg?
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This study comes from Regional Cancer Centre, Trivandrum, in the state of Kerala, South India. Regional Cancer Centre is a comprehensive cancer centre catering to the population of the State of Kerala and the adjoining states of Tamil Nadu and Karnataka. This study is an analysis of leukaemic phase, nodal and extranodal presentations of adult T cell leukaemia/lymphoma (ATLL) in our institute. This study aims to document the alarming incidence of ATLL in this part of South India. This study includes 32 cases, which were diagnosed as compatible with ATLL over a period of 26 months.Our diagnostic approach to a typical case starts with a detailed history, clinical examination with emphasis on skin lesions,evaluation of laboratory findings especially seurm calcium and lactate dehydrogenase values. A peripheral blood examination would be followed by ancillary tests like flow cytometric immunophenotyping of peripheral blood or histopathological examination with immunostaining of submitted tissue biopsy. The last step is the confirmatory serology test for serum human T cell lymphotropic virus type 1 (HTLV-1) antibody. We report for the first time from the state of Kerala, South India, 15 patients with HTLV-1-positive ATLL. This high incidence of ATLL in our state population hitherto not reported is worrisome and entails routine screening for serum HTLV-1 before invasive procedures and among voluntary blood donors in our population.
KeywordsNon-endemic Adult T cell leukaemia/lymphoma Kerala, India
Dr Mammen Chandy, eminent haematologist, presently Director, Tata Medical Center, Kolkata, India, for a thoughtful comment he made during a conference that most cases of ATLL he had seen were from the state of Kerala. Department of Radiotherapy, Medical college, Trivandrum for clinical photographs Fig. 3a–c. A part of this study was presented as a poster titled “Adult T-cell leukaemia / lymphoma (ATLL)—hot spot in South India” at the XVI Meeting of the European Association for Haematopathology October 20th–25th, 2012 in Lisbon, Portugal.
Conflict of interest
The authors declare that they have no conflict of interest.
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