Adult Tcell Leukemialymphoma

Human T-cell lymphotrophic virus type I (HTLV-I), the causative agent in adult T-cell leukemia-lymphoma, is uncommon in the United States. A case report of adult T-cell leukemia-lymphoma during pregnancy has been published.90 A 23-year-old female was admitted with a 1-week history of sore throat, fever, and fatigue during the 26th week of gestation. The WBC was 55,900/^L with 74% unclassified cells. Flow cytometry revealed increased numbers of CD3+, CD4+, and CD3-CD25 + T cells in her blood, and her bone marrow demonstrated 34% atypical, intermediate-size lymphocytes. IgG anti-HTLV-I or HTLV-II antibodies were present and HTLV-I was detected by a polymerase chain reaction assay. The patient was treated with hydroxyurea and CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) with a subsequent drop in her WBC to 12,700/^L. On the eighth day of admission, a healthy infant was delivered by cesarean section.90

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