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Adult T-cell leukemia/lymphoma in a Caucasian patient after sexual transmission of HTLV-1

  • David Sibon1, 2, 3,
  • Olivier Cassar4, 5,
  • Isabelle Duga6,
  • Chantal Brouzes7,
  • David Ghez8,
  • Christophe Pasquier9,
  • Claire Sibon10,
  • Alexandra Desrames4, 5,
  • Franck Mortreux11,
  • Eric Wattel11,
  • Ali Bazarbachi12,
  • Antoine Gessain4, 5 and
  • Olivier Hermine1, 2, 3
Retrovirology201512(Suppl 1):P76

Published: 28 August 2015


Breast MilkSexual IntercourseIntravenous DrugMolecular SubtypeCaucasian Patient

Adult T-cell leukemia/lymphoma (ATLL) is an aggressive T-cell lymphoproliferation caused by human T-cell lymphotropic virus type-1 (HTLV-1). This oncogenic human retrovirus can be acquired by mother-to-child transmission through prolonged breast-feeding, sexual transmission, or from transfused infected blood cells or intravenous drug abuse. HTLV-1 infects approximately 5–10 million individuals worldwide and, among them, 1–5% will develop ATLL during their lifetime. Four major geographic molecular subtypes (genotypes) have been reported including the cosmopolitan a-subtype, the Central African b-subtype, the Central African/Pygmies d-subtype and the Australo-Melanesian c-subtype. The results of several studies showed that most cases of ATLL develop in individuals who have been infected with HTLV-1 as young children via their mothers’ breast milk. The very rare ATLL cases observed following transfusion or sexual transmission are still being debated. Here, we report on a Caucasian French patient, with HTLV-1–seronegative parents, who developed ATLL, characterized by a clonal T cell skin proliferation of CD4+ and CD25+ cells, 18 years after highly probable sexual transmission of HTLV-1 through repeated unprotected sexual intercourse with a Cameroonian woman. Indeed, genotyping of the patient's virus revealed infection with an HTLV-1 b-subtype strain, typically of Central African origin, especially Cameroon. This case definitively confirms the hypothesis that ATLL can develop, albeit rarely, after infection during adulthood, outside breast-feeding.

Authors’ Affiliations

Hématologie Adulte, Hôpital Universitaire Necker–Enfants Malades, Assistance Publique– Hôpitaux de Paris (APHP), Paris, France
INSERM U1163 and CNRS ERL 8254 Bases Cellulaires et Moléculaires des Désordres Hématologiques, France
Institut Imagine, Université Paris Descartes– Sorbonne Paris Cité, Paris, France
Institut Pasteur, Unité d'Epidémiologie et Physiopathologie des Virus Oncogènes, Département de Virologie, Paris, France
CNRS, Paris, France
Département de Pathologie, Hôpital Purpan, Toulouse, France
Laboratoire d'Hématologie, Hôpital Universitaire Necker–Enfants Malades, Assistance Publique–Hôpitaux de Paris (APHP), Paris, France
Hématologie, Institut Gustave-Roussy, Villejuif, France
Laboratoire de Virologie, Hôpital Purpan, Toulouse, France
Département de Dermatologie, Hôpital Ambroise-Paré, Boulogne-Billancourt, France
Laboratoire d'Oncovirologie et Biothérapies, Lyon, France
Department of Internal Medicine, American University of Beirut, Beirut, Lebanon


© Sibon et al. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.