Análise epidemiológica da leucemia/linfoma de células T do adulto em hospital público universitário da Bahia: características clínicas e demográficas

Abstract

INTRODUCTION: Adult T-cell leukemia/lymphoma (ATLL) is a rare lymphoproliferative neoplasm associated with infection by human T-cell lymphotropic virus type 1 (HTLV-1), with a heterogeneous distribution and higher prevalence in endemic regions, such as the Brazilian Northeast. It is a clinically diverse disease that frequently presents aggressively and with an unfavorable prognosis..OBJECTIVE: To describe the epidemiological, clinical, laboratory, therapeutic, and prognostic characteristics of patients diagnosed with ATLL treated at a public university hospital located in an endemic region for HTLV-1. METHODS: Observational, retrospective, and descriptive study, with clinical follow-up when available, based on the review of medical records of patients with a confirmed diagnosis of ATLL followed between 2010 and 2023, with updated outcomes until 2025. Demographic, clinical, laboratory, therapeutic variables and clinical outcomes were analyzed using predominantly descriptive statistical analysis.RESULTS: Twenty-seven patients were included, predominantly female, with a median age at diagnosis lower than that reported in most international series. A high frequency of aggressive clinical subtypes and diagnosis at advanced stages, particularly stage IV, was observed. Laboratory markers associated with a worse prognosis, such as elevated lactate dehydrogenase, anemia, hypercalcemia, and hypoalbuminemia, were frequently identified. Therapeutic approaches were heterogeneous, including systemic chemotherapy, antiviral therapies, and supportive measures, with variable and, in many cases, limited responses. There was significant early mortality and important losses to follow-up, which prevented formal survival analyses. CONCLUSION: In this hospital cohort, ATLL presented as a disease of high clinical severity from diagnosis, marked by the predominance of aggressive forms, advanced staging, and unfavorable outcomes. These findings reflect not only the aggressive biology of the disease, but also the healthcare challenges faced in endemic regions, reinforcing the importance of early diagnosis and strengthening clinical follow-up within the public health system.