T-cell leukemia natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2]

Natural History

• The natural history of adult T-cell leukemia varies between the different subtypes of the disease.
• Usually patients with acute adult T-cell leukemia have an aggressive clinical course with a median survival period of less than 12 months. If left untreated, most of the patients with acute adult T-cell leukemia will develop systemic symptoms, lymphadenopathy, and organomegaly within a few weeks of diagnosis.
• Usually patients with chronic adult T-cell leukemia will have an stable clinical course. If left untreated, most of the patients with chronic adult T-cell leukemia will develop lymphocytosis for months, or even years, before presenting with the typical skin manifestations.
• Most patients with smouldering adult T cell leukemia are initially asymptomatic. If left untreated, most of the patients with smouldering adult T cell leukemia will develop steroid-responsive skin rash and multiple lung infiltrates.

Complications

• Common complications of adult T-cell leukemia include:

• Cardiac arrhythmias (due to hypercalcaemia)
• Opportunistic infections (due to defective immune system)
• Bone fractures (due to lytic bone lesions)