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Low prevalence of flower cells in U.S.A. blood donors infected with human T‐lymphotrophic virus types I and II
Author(s) -
Sacher Ronald A.,
Luban Naomi L. C.,
Ameti Dannie I.,
Friend Shirley,
Schreiber George B.,
Murphy Edward L.
Publication year - 1999
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.1999.01408.x
Subject(s) - serostatus , medicine , lymphocyte , immunology , basophilic , virus , biology , virology , pathology , viral load
Large lymphocytes with basophilic cytoplasm and cleaved/cerebriform nuclei called flower cells have been described in human T‐lymphotrophic virus type I (HTLV‐I) seropositive individuals and may be precursors of adult T‐cell leukaemia (ATL). A cohort of 546 HTLV‐seropositive former blood donors, 32 HTLV‐positive sexual partners of these donors and 799 HTLV‐seronegative controls has been followed as part of the Retrovirus Epidemiology Donor Study. A novel methodology was developed to systematically review peripheral blood slides from these subjects for HTLV‐related lymphocyte abnormalities, using an algorithm based on morphologic features to objectively identify flower cells. The algorithm included: absence of azurophil granules; nuclear chromatin condensation; cell size >1.5 small lymphocytes; nuclear to cytoplasmic ratio >80%; and presence of nuclear folding/lobulation. Peripheral slides from subjects were screened by a medical technologist blinded to HTLV status. 6.8% of HTLV‐I subjects ( P = 0.0001 versus seronegatives), 0.9% of HTLV‐II subjects and 1.1% of seronegatives were confirmed to have cells classified as flower cells by two haematologists using objective criteria, and blinded to serostatus. Despite the higher prevalence of flower cells in HTLV‐I positives, no clinical correlations were found. Longitudinal follow‐up may yield higher rates of cellular abnormalities as the sequelae of HTLV infection develop.