Effect of Human T-Lymphotropic Virus Type I Infection on Non-Hodgkin's Lymphoma Incidence

Background: We previously reported from a case—control analysis that T-cell non-Hodgkin's lymphoma (NHL) was strongly associated with human T-lym-photropic virus type I (HTLV-I) infection in Jamaica and Trinidad and that the relative risk for HTLV-I infection was very high in younger patients....

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Bibliographic Details
Published in:JNCI : Journal of the National Cancer Institute 1995-07, Vol.87 (13), p.1009-1014
Main Authors: Cleghorn, Farley R., Manns, Angela, Falk, Roni, Hartge, Patricia, Hanchard, Barrie, Jack, Noreen, williams, Elaine, jaffe, Elaine, White, Franklin, Bartholomew, Courtenay, Blattner, William
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age Distribution
Aged
AIDS/HIV
Biological and medical sciences
Cancer
Child
Child, Preschool
Female
Hematologic and hematopoietic diseases
HTLV-I Infections - complications
Humans
Incidence
Infant
Jamaica - epidemiology
Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis
Lymphoma, Non-Hodgkin - epidemiology
Lymphoma, Non-Hodgkin - virology
Male
Medical research
Medical sciences
Middle Aged
Phenotype
Sex Distribution
Trinidad and Tobago - epidemiology
Viruses
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Summary:Background: We previously reported from a case—control analysis that T-cell non-Hodgkin's lymphoma (NHL) was strongly associated with human T-lym-photropic virus type I (HTLV-I) infection in Jamaica and Trinidad and that the relative risk for HTLV-I infection was very high in younger patients. Purpose: The objective of this study was to estimate the age-specific incidence rates of NHL among HTLV-I-infected and HTLV-I-uninfected adults in Jamaica and Trinidad. Methods: Population rates of HTLV-I infection were calculated from available census reports and serosurvey data. Incidence rates for NHL were calculated from all incident cases in Jamaica during 1984–1987 (n = 135) and from all incident cases in Trinidad during 1986–1990 (n = 117). Using biopsy material, we determined whether the immuno-phenotype of the tumor cells was T cell, B cell, or other. NHL incidence rates were computed according to HTLV-I status, age, sex, and tumor phenotype for each country separately and for both countries combined by weighting to the relative population size of each country. Results: The age-standardized NHL incidence rate (mean ± SE) in Jamaica was 1.9 ± 0.2 per 100 000 person-years (PY). In Trinidad, the rate was 2.9 ± 0.4 per 100 000 PY. Overall, the incidence of NHL increased with age and was higher in males than in females. In the HTLV-I-infected population, the incidence of NHL was inversely related to age, and age-specific rates were higher in males than in females. The NHL incidence in those estimated to have acquired HTLV-I infection in childhood, however, showed no sex difference, and one in 1300 such carriers (95% confidence interval: one in 1100 to one in 1600) per annum were estimated to be at such risk. For T-cell NHL, as proxy for adult T-cell lym-phoma/leukemia, incidence was highest in those patients infected with HTLV-I early in life (perinatally or via breast milk), with high, sustained risk from early adulthood in both sexes. Conclusions: While overall NHL incidence rates reveal that HTLV-I endemicity does not impose an exaggerated lymphoma burden on these populations, the risk for lymphoma among carriers who acquire infection early in life is dramatic and is consistent with the hypothesis that virus exposure early in life is most important for lymphoma-genesis. Implications: Studies of HTLV-I carriers known to be infected in childhood may provide insight into markers intermediate in the lympho-magnetic process. Strategies to disrupt early-life transmi
ISSN:0027-8874
1460-2105
DOI:10.1093/jnci/87.13.1009