Adult T-cell leukemia classification

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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]

Overview

Based on both the clinical presentation and laboratory findings, adult T-cell leukemia may be classified into either an acute variant, chronic variant, smoldering variant, or an adult T-cell lymphoma variant.

Classification

• Based on both the clinical presentation and laboratory findings, adult T-cell leukemia may be classified into either an acute variant, chronic variant, smouldering variant, or an adult T-cell lymphoma variant.
• The table below lists the adult T-cell leukemia clinical classification details:

Clinical Variant	Description
Acute adult T-cell leukemia	Leukemic clinical presentation Organomegaly present Markedly elevated lactate dehydrogenase (LDH) level Hypercalcaemia
Chronic adult T-cell leukemia	Lymphocyte count greater than 4×109/L Cutaneous, pulmonary, and hepatic involvement Lymphadenopathy Normal serum LDH level (or less that twice the normal upper limit) Normal serum calcium level
Primary cutaneous tumoral (PCT)	Cutaneous involvement. Nodules on the skin. Poor prognosis. Normal serum LDH level (or less that twice the normal upper limit) Normal serum calcium level
Smoldering adult T-cell leukemia	Cutaneous and/or pulmonary infiltrates No other organ involvement Normal lymphocyte count (1–5% ATLL cells) Normal serum LDH level Normal serum calcium level
Adult T-cell lymphoma	Organomegaly present Less than 1% leukemic cells in the circulation Elevated serum LDH level Hypercalcemia