adult T-cell leukemia-lymphoma (redirected from smoldering)

adult T-cell leukemia-lymphoma

Oncology A rapidly-progressive lymphoproliferative malignancy of mature T lymphocytes, commonly associated with infection by the retrovirus, HTLV-I, first described in southeastern Japan, also seen in the Caribbean, Africa and in blacks in the southeastern US, in whom the disease is aggressive with skin lesions, hypercalcemia, rapid enlargement of hilar, retroperitoneal and peripheral lymph nodes with mediastinal sparing, invasion of CNS, lungs, GI tract, opportunistic infections–eg, Pneumocystis carinii. See T-cell lymphoma

Adult T-cell leukemia-lymphoma–clinical forms

Acute

Median age 52, lymphadenopathy, hepatosplenomegaly, cutaneous lesions, up to a 20-year latency, often resistant to chemotherapy with poor prognosis following disease onset Lab ↑ Ca^{++, WBCs 10-500 × 109–US: 10-500 000/mm3, Sezary-like cells with CD3, CD4, CD2, and Tac+ surface antigens, causing a chronic, smoldering lymphoma}

Chronic

Clinically between acute and smoldering disease

Smoldering

Characterized by erythematous skin nodules filled with lymphocytes that may undergo 'blast transformation' to the typical acute T cell leukemia

Crisis

When either 2. or 3. transform to ATL

Lymphoma

Most common in US; affects blacks with hypercalcemia, leukemia, hepatosplenomegaly, erythematous skin lesions, lytic bone lesions