Risk stratification of adult T-cell leukemia/lymphoma using immunophenotyping

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• 作者：Huseini H. Kagdi ; Maria A. Demontis ; Paul A. Fields ; Juan Carlos Ramos ; Charles R. M. Bangham and Graham P. Taylor
• 刊名：Cancer Medicine
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：6
• 期：1
• 页码：298-309
• 全文大小：610K
• ISSN：2045-7634

文摘

Adult T-cell leukemia/lymphoma (ATL), a human T-lymphotropic virus type 1 (HTLV-1)-associated disease, has a highly variable clinical course and four subtypes with therapeutic and prognostic implications. However, there are overlapping features between ATL subtypes and between ATL and nonmalignant (non-ATL) HTLV-1 infection complicating diagnosis and prognostication. To further refine the diagnosis and prognosis of ATL, we characterized the immunophenotype of HTLV-1-infected cells in ATL and non-ATL. A retrospective study of peripheral blood samples from 10 HTLV-1-uninfected subjects (UI), 54 HTLV-1-infected patients with non-ATL, and 22 with ATL was performed using flow cytometry. All patients with ATL had CD4⁺ CCR4⁺ CD26⁻ immunophenotype and the frequency of CD4⁺ CCR4⁺ CD26⁻ T cells correlated highly significantly with the proviral load in non-ATL suggesting CD4⁺ CCR4⁺ CD26⁻ as a marker of HTLV-1-infected cells. Further immunophenotyping of CD4⁺ CCR4⁺ CD26⁻ cells revealed that 95% patients with ATL had a CD7⁻ (≤30% CD7⁺ cells), whereas 95% HTLV+ non-ATL had CD7⁺ (>30% CD7⁺ cells) immunophenotype. All patients with aggressive ATL had a CCR7⁺ (≥30%), whereas 92% with indolent ATL and 100% non-ATL had a CCR7⁻ (<30%) immunophenotype. Patients with nonprogressing indolent ATL were CD127⁺ but those with progressive lymphocytosis requiring systemic therapy had a CD127⁻ (≤30%) immunophenotype. In summary, HTLV-1-infected cells have a CD4⁺ CCR4⁺ CD26⁻ immunophenotype. Within this population, CD7⁻ phenotype suggests a diagnosis of ATL, CCR7⁺ phenotype identifies aggressive ATL, while CCR7⁻ CD127⁻ phenotype identifies progressive indolent ATL.