Adult T cell leukaemia/lymphoma (ATL) in pregnancy: A UK case series.
Motedayen Aval L., Boullier M., Lyall H., Collins GP., Ayto R., Kelly DF., Tedder RS., Drysdale SB., Taylor GP., Cook LB.
INTRODUCTION: Chronic infection with human T-cell lymphotropic virus type-1 (HTLV-1) may result in aggressive adult T-cell leukaemia/lymphoma (ATL) in 4-6% carriers. The majority of this risk arises in carriers infected during infancy, and so each infant has ∼25% lifetime risk. Other risk factors include a family history of ATL. Antenatal HTLV-1 screening is not undertaken in the UK. METHODS: Here we describe four cases of ATL diagnosed during pregnancy and describe strategies to minimise HTLV-1 transmission to neonates. RESULTS/CONCLUSION: These cases highlight undiagnosed HTLV-1 in pregnancy which allows ongoing mother to child vertical transmission and risk of future ATL. We recommend the UK National Screening Committee incorporate HTLV-1 serology into antenatal screening.