Unique evidence of atypical lymphocytes and flower cells in indigenous Xikrin do Bacajá people infected with HTLV-2

Abstract

The presence of lymphocytic alterations in the blood of indigenous people infected with human T-lymphotropic virus 2 (HTLV-2) was investigated in peripheral blood smears from 25 indigenous people of the Xikrin do Bacajá ethnicity (11 men and 14 women) diagnosed with HTLV-2 infection by Western blot and qPCR. Smears were stained using the Leishman method and examined for lymphocyte morphology under an optical microscope. A group of 25 individuals seronegative for HTLV-1/2 infection were used as controls. Among the HTLV-2-infected group, six slides (24%) showed atypical lymphocytes (05 with atypical lymphocytes and 01 with petal-shaped nuclei usually referred to as flower cells). The finding was significantly different from that observed among the noninfected group, in which no lymphocytic alteration was observed (p=0.0223). This unique finding is reported for the first time among indigenous peoples and suggests that HTLV-2 infection may be associated with lymphocytic alterations, reinforcing the need for a larger and more detailed clinical study of people living with HTLV-2, particularly the indigenous populations of the Amazon in which the infection is hyperendemic.