Adult T-Cell Leukemia/Lymphoma and Targeted Maternal Screening

Does adult T-cell leukemia/lymphoma (ATLL) incidence among non-Hispanic Caribbean-born US residents reach levels that justify maternal human T-cell leukemia virus type 1 (HTLV-1) screening, as implemented in historically endemic regions?In this population-based cross-sectional analysis of 3228 individuals with ATLL (diagnosed, 2005-2022), incidence among non-Hispanic Caribbean-born US residents was substantially higher than among US-born or Canada-born populations and, after accounting for diagnostic misclassification with peripheral T-cell lymphoma not otherwise specified, approached levels reported in southwestern Japan.ATLL arises from early-life HTLV-1 infection via breastfeeding, making maternal transmission an actionable cancer prevention target in the US for high-risk populations.

Corresponding Author: Paulo S. Pinheiro, MD, PhD, University of Miami School of Medicine, 1120 NW 14th St, (R-1077), Clinical Research Bldg, Ste 913, Miami, FL 33136-2107 (ppinheiro@med.miami.edu).

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