       Document 0298
 DOCN  M95B0298
 TI    Effect of human T-lymphotropic virus type I infection on non-Hodgkin's
       lymphoma incidence [see comments]
 DT    9511
 AU    Cleghorn FR; Manns A; Falk R; Hartge P; Hanchard B; Jack N; Williams E;
       Jaffe E; White F; Bartholomew C; et al; Division of Cancer Etiology,
       National Cancer Institute, National; Institutes of Health, Bethesda, MD,
       USA.
 SO    J Natl Cancer Inst. 1995 Jul 5;87(13):1009-14. Unique Identifier :
       AIDSLINE MED/95356226
 CM    Comment in: J Natl Cancer Inst 1995 Jul 5;87(13):947-9
 AB    BACKGROUND: We previously reported from a case-control analysis that
       T-cell non-Hodgkin's lymphoma (NHL) was strongly associated with human
       T-lymphotropic 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 immunophenotype 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 lymphoma/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
       transmission of HTLV-I, notably mother-infant transmission, may be
       critical in reducing the burden of lymphoreticular disease in these
       populations.
 DE    Adolescence  Adult  Age Distribution  Aged  Child  Child, Preschool
       Female  Human  HTLV-I Infections/*COMPLICATIONS  Incidence  Infant
       Jamaica/EPIDEMIOLOGY  Lymphoma, Non-Hodgkin's/*EPIDEMIOLOGY/*VIROLOGY
       Male  Middle Age  Phenotype  Sex Distribution  Trinidad and
       Tobago/EPIDEMIOLOGY  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

