Risk stratification of adult T-cell leukemia/lymphoma using immunophenotyping

Huseini H. Kagdi, Maria A. Demontis, Paul A. Fields, Juan Carlos Ramos, Charles R.M. Bangham, Graham P. Taylor

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Adult T-cell leukemia/lymphoma (ATL), a human T-lymphotropic virus type 1 (HTLV-1)-associated disease, has a highly variable clinical course and four subtypes with therapeutic and prognostic implications. However, there are overlapping features between ATL subtypes and between ATL and nonmalignant (non-ATL) HTLV-1 infection complicating diagnosis and prognostication. To further refine the diagnosis and prognosis of ATL, we characterized the immunophenotype of HTLV-1-infected cells in ATL and non-ATL. A retrospective study of peripheral blood samples from 10 HTLV-1-uninfected subjects (UI), 54 HTLV-1-infected patients with non-ATL, and 22 with ATL was performed using flow cytometry. All patients with ATL had CD4+ CCR4+ CD26 immunophenotype and the frequency of CD4+ CCR4+ CD26 T cells correlated highly significantly with the proviral load in non-ATL suggesting CD4+ CCR4+ CD26 as a marker of HTLV-1-infected cells. Further immunophenotyping of CD4+ CCR4+ CD26 cells revealed that 95% patients with ATL had a CD7 (≤30% CD7+ cells), whereas 95% HTLV+ non-ATL had CD7+ (>30% CD7+ cells) immunophenotype. All patients with aggressive ATL had a CCR7+ (≥30%), whereas 92% with indolent ATL and 100% non-ATL had a CCR7 (<30%) immunophenotype. Patients with nonprogressing indolent ATL were CD127+ but those with progressive lymphocytosis requiring systemic therapy had a CD127 (≤30%) immunophenotype. In summary, HTLV-1-infected cells have a CD4+ CCR4+ CD26 immunophenotype. Within this population, CD7 phenotype suggests a diagnosis of ATL, CCR7+ phenotype identifies aggressive ATL, while CCR7 CD127 phenotype identifies progressive indolent ATL.

Original languageEnglish (US)
Pages (from-to)298-309
Number of pages12
JournalCancer Medicine
Issue number1
StatePublished - Jan 1 2017


  • Adult T-cell leukemia/lymphoma (ATL)
  • chemokine receptor(s)
  • human T-lymphotropic virus type 1 (HTLV-1)
  • immunophenotyping
  • interleukin receptor(s)

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research


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