Only a small number of cases of lymphoma due to human T-cell lymphotrophic virus (HTLV) type 1 have occurred in British Columbia patients. This type of lymphoma should be suspected in patients who develop a syndrome of widespread lymphoma involving skin and bone or bone marrow, often associated with hypercalcemia. Origin from, or previous residence in Southern Japan or the Caribbean Basin, where this virus is endemic, should also suggest possible HTLV disease.
Treatment of HTLV associated lymphoma requires intensive multi-agent chemotherapy. Because of the rarity of this disease and its aggressive nature, management should be discussed with a Core Member of the Lymphoma Tumour Group. Special attention should be directed at the tendency of this type of lymphoma to involve the CNS and the need for family screening and counselling for presence of HTLV which can be spread by sexual contact or from body fluids. A screening test for presence of antibody to HTLV-1 is available. Information about this test should be obtained from one of the pathologist Core Members.