HTLV‐I‐positive and HTLV‐I‐negative peripheral T‐cell lymphomas in Taiwan Chinese

The clinico‐pathologic features of 107 adult Chinese patients with peripheral T‐cell lymphoma (excluding primary cutaneous lymphoma) are described and a comparison between HTLV‐I⁺ and HTLV‐I⁻patients is made. There were 27 HTLV‐I⁺ and 80 HTLV‐I⁻patients. The virus‐positive and‐negative groups both had a male predominance and an identical median age of 48. Most patients in both groups presented with stage‐IV disease, B symptoms, lymphadenopathy and hepatosplenomegaly. The HTLV‐I⁺ group had a significantly higher incidence of skin and pulmonary lesions, bone marrow and peripheral blood involvement, hypercalcemia, and elevated LDH level compared to the HTLV‐I⁻group. Sinonasal lesions (10), mediastinal mass (5), and GI tract involvement (6) were only seen in the HTLV‐I⁻group. Leukocytosis with the presence of circulating pleomorphic lymphoid cells was characteristic of HTLV‐I⁺ cases, while cytopenia was more frequently present in HTLV‐I⁻cases. All of the 24 HTLV‐I⁺ patients tested were CD4⁺CD8⁻; of the 67 HTLV‐I⁻patients tested, 46 were CD4⁺CD8⁻, 9 were CD4⁻CD8⁺, 5 were CD4⁻CD8⁻and 7 were CD4⁺CD8⁺. Phenotypic studies revealed significant differences in the expression of CD7 and CD25 between virus‐positive and‐negative groups. Both groups responded poorly to therapy. The median survival of HTLV‐I+ and HTLV‐I⁻patients was 4 months and 13.5 months, respectively. Apart from the presence of more than 3 extranodal lesions, none of the other clinical features or histologic subtypes had prognostic significance in the entire group or either of the subgroups. This series of peripheral T‐cell lymphomas in Taiwan indicate that HTLV‐I⁺ and HTLV‐I⁻patients had many features in common, but presented several distinct differences.