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Abdelmoumen K, Alsibai KD, Rabier S, Nacher M, Wankpo NB, Gessain A, Santa F, Hermine O, Marçais A, Couppié P, Droz JP, Epelboin L. Adult T-cell leukemia and lymphoma in French Guiana: a retrospective analysis with real-life data from 2009 to 2019. Lancet Reg Health Am 2023; 21:100492. [PMID: 37139265 PMCID: PMC10149364 DOI: 10.1016/j.lana.2023.100492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 02/18/2023] [Accepted: 03/28/2023] [Indexed: 05/05/2023]
Abstract
Background Adult T-cell leukemia/lymphoma (ATL), one of the most aggressive cancers in the world, occurs in 5% of the 10 million people living with HTLV-1 worldwide. French Guiana, a French overseas territory in South America, is one of the highest endemic areas of HTLV-1 worldwide. Here, we describe the demographic and clinical characteristics and outcome of ATL in this area. Methods We retrospectively collected data from all patients diagnosed between 2009 and 2019. Patients were distributed according to Shimoyama's classification. Prognostic factors were explored through univariate analysis. Findings Over the 10-year study period, 41 patients with a median age of 54 years at diagnosis were identified, among whom 56% were women. Sixteen (39%) patients were Maroons, a cultural group descendant of the runaway enslaved Africans from former Dutch Guiana. Among the study population, 23 (56%) had an acute type, 14 (34%) a lymphoma type, and one and one chronic and primary cutaneous tumour, respectively. First-lines of treatment included either chemotherapy or Zidovudine combined with pegylated interferon alpha. The 4-year overall survival was 11.4% for the entire population with 0% and 11% for lymphoma and acute forms, respectively. The median progression-free survival was 93 and 115 days for the acute and lymphoma groups (p = 0.37), respectively. Among the twenty-nine patients who died, 8 (28%) died of toxicity, 7 (24%) died of disease progression and the cause of death remained unknown in 14 (48%) patients. Due to the overall poor prognosis, no significant prognostic factors could be identified. Interpretation This study provides real-life data from ATL patients in French Guiana, a remote territory in a middle-income region. Patients, mostly Maroons, presented with a younger age and the prognosis was worse than expected compared to Japanese patients. Funding None.
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Affiliation(s)
- Karim Abdelmoumen
- Department of Internal Medicine, University of la Réunion, Reunion Island, France
- Department of Dermatology, Cayenne Hospital, French Guiana, France
- Corresponding author. Université de La Réunion, département de médecine interne, Site du Tampon-Campus Sud, 117 Rue du Général Ailleret, 97430 Le Tampon, La Réunion; Unité des Maladies infectieuses et tropicales, CH de Cayenne Andrée Rosemon, 97300, French Guiana, France.
| | | | | | - Mathieu Nacher
- Centre d’Investigation Clinique Antilles Guyane – CIC Inserm 1424, Centre Hospitalier de Cayenne Andrée Rosemon, and French Guiana University, French Guiana, France
| | - N'detodji-Bill Wankpo
- Oncology Program, Centre Hospitalier de l’Ouest-Guyane, Saint-Laurent du Maroni, French Guiana, France
| | - Antoine Gessain
- Epidemiology and Physiopathology of Oncogenic Viruses, Pasteur Institute, Paris, France
| | - Florin Santa
- Department of Oncology, Cayenne Hospital, French Guiana, France
| | - Olivier Hermine
- Department of Hematology, Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris, INSERM UMR 1163 et CNRS ERL 8254, Institut Imagine, Université Paris Cité, Paris, France
| | - Ambroise Marçais
- Department of Hematology, Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris, INSERM UMR 1151 and CNRS, Institut Necker, Université Paris Cité, Paris, France
| | - Pierre Couppié
- Department of Dermatology, Cayenne Hospital, French Guiana, France
| | - Jean-Pierre Droz
- Department of Medical Oncology, Centre Léon-Bérard, Lyon, France
- Claude-Bernard Lyon University, Lyon, France
| | - Loïc Epelboin
- Corevih Guyane, Cayenne Hospital, French Guiana, France
- Infectious and Tropical Diseases Unit, Cayenne Hospital and French Guiana University, French Guiana, France
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Epelboin L, Abboud P, Abdelmoumen K, About F, Adenis A, Blaise T, Blaizot R, Bonifay T, Bourne-Watrin M, Boutrou M, Carles G, Carlier PY, Carod JF, Carvalho L, Couppié P, De Toffol B, Delon F, Demar M, Destoop J, Douine M, Droz JP, Elenga N, Enfissi A, Franck YK, Fremery A, Gaillet M, Kallel H, Kpangon AA, Lavergne A, Le Turnier P, Maisonobe L, Michaud C, Mutricy R, Nacher M, Naldjinan-Kodbaye R, Oberlis M, Odonne G, Osei L, Pujo J, Rabier S, Roman-Laverdure B, Rousseau C, Rousset D, Sabbah N, Sainte-Rose V, Schaub R, Sylla K, Tareau MA, Tertre V, Thorey C, Vialette V, Walter G, Zappa M, Djossou F, Vignier N. [Overview of infectious and non-infectious diseases in French Guiana in 2022]. Med Trop Sante Int 2023; 3:mtsi.v3i1.2023.308. [PMID: 37389381 PMCID: PMC10300792 DOI: 10.48327/mtsi.v3i1.2023.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 09/15/2022] [Indexed: 07/01/2023]
Abstract
Source of many myths, French Guiana represents an exceptional territory due to the richness of its biodiversity and the variety of its communities. The only European territory in Amazonia, surrounded by the Brazilian giant and the little-known Suriname, Ariane 6 rockets are launched from Kourou while 50% of the population lives below the poverty line. This paradoxical situation is a source of health problems specific to this territory, whether they be infectious diseases with unknown germs, intoxications or chronic pathologies.Some infectious diseases such as Q fever, toxoplasmosis, cryptococcosis or HIV infection are in common with temperate countries, but present specificities leading to sometimes different management and medical reasoning. In addition to these pathologies, many tropical diseases are present in an endemic and / or epidemic mode such as malaria, leishmaniasis, Chagas disease, histoplasmosis or dengue. Besides, Amazonian dermatology is extremely varied, ranging from rare but serious pathologies (Buruli ulcer, leprosy) to others which are frequent and benign such as agouti lice (mites of the family Trombiculidae) or papillonitis. Envenomations by wild fauna are not rare, and deserve an appropriate management of the incriminated taxon. Obstetrical, cardiovascular and metabolic cosmopolitan pathologies sometimes take on a particular dimension in French Guiana that must be taken into account in the management of patients. Finally, different types of intoxication are to be known by practitioners, especially due to heavy metals.European-level resources offer diagnostic and therapeutic possibilities that do not exist in the surrounding countries and regions, thus allowing the management of diseases that are not well known elsewhere.Thanks to these same European-level resources, research in Guyana occupies a key place within the Amazon region, despite a smaller population than in the surrounding countries. Thus, certain pathologies such as histoplasmosis of the immunocompromised patient, Amazonian toxoplasmosis or Q fever are hardly described in neighboring countries, probably due to under-diagnosis linked to more limited resources. French Guiana plays a leading role in the study of these diseases.The objective of this overview is to guide health care providers coming to or practicing in French Guiana in their daily practice, but also practitioners taking care of people returning from French Guiana.
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Affiliation(s)
- Loïc Epelboin
- Unité des maladies infectieuses et tropicales, Centre hospitalier de Cayenne, Cayenne, Guyane
- Centre d'investigation clinique Guyane (Inserm CIC 1424), Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Philippe Abboud
- Unité des maladies infectieuses et tropicales, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Karim Abdelmoumen
- Département des maladies infectieuses, Centre hospitalier de Mayotte, Mamoudzou, Mayotte
| | - Frédégonde About
- Unité des maladies infectieuses et tropicales, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Antoine Adenis
- Centre d'investigation clinique Guyane (Inserm CIC 1424), Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Théo Blaise
- Centre d'investigation clinique Guyane (Inserm CIC 1424), Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Romain Blaizot
- Unité carcérale de soins ambulatoires, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Timothée Bonifay
- Unité carcérale de soins ambulatoires, Centre hospitalier de Cayenne, Cayenne, Guyane
| | | | - Mathilde Boutrou
- Unité des maladies infectieuses et tropicales, Centre hospitalier de Cayenne, Cayenne, Guyane
- Centre d'investigation clinique Guyane (Inserm CIC 1424), Centre hospitalier de Cayenne, Cayenne, Guyane
- Département des maladies infectieuses, Centre hospitalier de Mayotte, Mamoudzou, Mayotte
- Unité carcérale de soins ambulatoires, Centre hospitalier de Cayenne, Cayenne, Guyane
- Service de dermatologie, Centre hospitalier de Cayenne, Cayenne, Guyane
- Service de gynécologie-obstétrique, Centre hospitalier de l'ouest guyanais, Saint-Laurent-du-Maroni, Guyane
- Laboratoire de biologie médicale, Centre hospitalier de l'ouest guyanais, Saint-Laurent-du-Maroni, Guyane
- Agence régionale de santé de Guyane, Cayenne, Guyane
- Santé publique France, Cayenne, Guyane
- Service de neurologie, Centre hospitalier de Cayenne, Cayenne, Guyane
- TBIP (Tropical Biome and ImmunoPhysiopathology), Université de Guyane, Cayenne, Guyane
- Laboratoire hospitalo-universitaire de parasitologie et mycologie, Centre hospitalier de Cayenne Andrée-Rosemon, Cayenne, Guyane
- Université Claude Bernard Lyon 1 et Centre Léon Bérard, Lyon, France
- Service de pédiatrie, Centre hospitalier de Cayenne, Cayenne, Guyane
- Laboratoire de virologie, Institut Pasteur de la Guyane
- Service de cardiologie, Centre hospitalier de Cayenne, Cayenne, Guyane
- Service d'accueil des urgences et SAMU, Centre hospitalier de Cayenne, Cayenne, Guyane
- Pôle des Centres délocalisés de prévention et de soins, Centre hospitalier de Cayenne, Cayenne, Guyane
- Service de réanimation, Centre hospitalier de Cayenne, Cayenne, Guyane
- Service de médecine, Centre hospitalier de Kourou, Kourou, Guyane
- Laboratoire des interactions virus-hôtes, Institut Pasteur de la Guyane, Cayenne, Guyane
- Croix-Rouge française de Guyane, Cayenne, Guyane
- Laboratoire Écologie, évolution, interactions des systèmes amazoniens (LEEISA), CNRS, Université de Guyane, IFREMER, Cayenne, Guyane
- COREVIH (Comité de coordination de la lutte contre les infections sexuellement transmissibles et le virus de l'immunodéficience humaine), Centre hospitalier de Cayenne, Cayenne, Guyane
- Service d'endocrinologie-diabétologie et maladies métaboliques, Centre hospitalier de Cayenne, Cayenne, Guyane
- Service de médecine, Centre hospitalier de l'ouest guyanais, Saint-Laurent-du-Maroni, Guyane
- Direction interarmées du service de santé (DIASS)
- Laboratoire Eurofins Guyane, site de Kourou, Centre hospitalier de Kourou, Guyane
- Service de radiologie, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Gabriel Carles
- Service de gynécologie-obstétrique, Centre hospitalier de l'ouest guyanais, Saint-Laurent-du-Maroni, Guyane
| | | | - Jean-François Carod
- Laboratoire de biologie médicale, Centre hospitalier de l'ouest guyanais, Saint-Laurent-du-Maroni, Guyane
| | | | - Pierre Couppié
- Service de dermatologie, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Bertrand De Toffol
- Centre d'investigation clinique Guyane (Inserm CIC 1424), Centre hospitalier de Cayenne, Cayenne, Guyane
- Service de neurologie, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - François Delon
- Laboratoire Eurofins Guyane, site de Kourou, Centre hospitalier de Kourou, Guyane
| | - Magalie Demar
- TBIP (Tropical Biome and ImmunoPhysiopathology), Université de Guyane, Cayenne, Guyane
- Laboratoire hospitalo-universitaire de parasitologie et mycologie, Centre hospitalier de Cayenne Andrée-Rosemon, Cayenne, Guyane
| | - Justin Destoop
- Service de dermatologie, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Maylis Douine
- Centre d'investigation clinique Guyane (Inserm CIC 1424), Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Jean-Pierre Droz
- Université Claude Bernard Lyon 1 et Centre Léon Bérard, Lyon, France
| | - Narcisse Elenga
- Service de pédiatrie, Centre hospitalier de Cayenne, Cayenne, Guyane
| | | | - Yves-Kénol Franck
- Service de cardiologie, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Alexis Fremery
- Service d'accueil des urgences et SAMU, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Mélanie Gaillet
- Pôle des Centres délocalisés de prévention et de soins, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Hatem Kallel
- Service de réanimation, Centre hospitalier de Cayenne, Cayenne, Guyane
| | | | - Anne Lavergne
- Laboratoire des interactions virus-hôtes, Institut Pasteur de la Guyane, Cayenne, Guyane
| | - Paul Le Turnier
- Unité des maladies infectieuses et tropicales, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Lucas Maisonobe
- Unité des maladies infectieuses et tropicales, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Céline Michaud
- Pôle des Centres délocalisés de prévention et de soins, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Rémi Mutricy
- Service d'accueil des urgences et SAMU, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Mathieu Nacher
- Centre d'investigation clinique Guyane (Inserm CIC 1424), Centre hospitalier de Cayenne, Cayenne, Guyane
| | | | | | - Guillaume Odonne
- Laboratoire Écologie, évolution, interactions des systèmes amazoniens (LEEISA), CNRS, Université de Guyane, IFREMER, Cayenne, Guyane
| | - Lindsay Osei
- Service de pédiatrie, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Jean Pujo
- Service d'accueil des urgences et SAMU, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Sébastien Rabier
- Centre d'investigation clinique Guyane (Inserm CIC 1424), Centre hospitalier de Cayenne, Cayenne, Guyane
- COREVIH (Comité de coordination de la lutte contre les infections sexuellement transmissibles et le virus de l'immunodéficience humaine), Centre hospitalier de Cayenne, Cayenne, Guyane
| | | | - Cyril Rousseau
- Santé publique France, Cayenne, Guyane
- Pôle des Centres délocalisés de prévention et de soins, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Dominique Rousset
- Laboratoire hospitalo-universitaire de parasitologie et mycologie, Centre hospitalier de Cayenne Andrée-Rosemon, Cayenne, Guyane
| | - Nadia Sabbah
- Service d'endocrinologie-diabétologie et maladies métaboliques, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Vincent Sainte-Rose
- Laboratoire hospitalo-universitaire de parasitologie et mycologie, Centre hospitalier de Cayenne Andrée-Rosemon, Cayenne, Guyane
| | - Roxane Schaub
- Centre d'investigation clinique Guyane (Inserm CIC 1424), Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Karamba Sylla
- Service de médecine, Centre hospitalier de l'ouest guyanais, Saint-Laurent-du-Maroni, Guyane
| | - Marc-Alexandre Tareau
- Centre d'investigation clinique Guyane (Inserm CIC 1424), Centre hospitalier de Cayenne, Cayenne, Guyane
- Laboratoire Écologie, évolution, interactions des systèmes amazoniens (LEEISA), CNRS, Université de Guyane, IFREMER, Cayenne, Guyane
| | | | - Camille Thorey
- Service de médecine, Centre hospitalier de l'ouest guyanais, Saint-Laurent-du-Maroni, Guyane
| | - Véronique Vialette
- Laboratoire Eurofins Guyane, site de Kourou, Centre hospitalier de Kourou, Guyane
| | - Gaëlle Walter
- Unité des maladies infectieuses et tropicales, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Magaly Zappa
- Service de radiologie, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Félix Djossou
- Unité des maladies infectieuses et tropicales, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Nicolas Vignier
- Centre d'investigation clinique Guyane (Inserm CIC 1424), Centre hospitalier de Cayenne, Cayenne, Guyane
- COREVIH (Comité de coordination de la lutte contre les infections sexuellement transmissibles et le virus de l'immunodéficience humaine), Centre hospitalier de Cayenne, Cayenne, Guyane
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