Multi‐step Carcinogenesis Model for Adult T‐cell Leukemia

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Abstract
The age‐specific occurrence of adult T‐cell leukemia (ATL) was analyzed using 357 cases collected during nationwide surveys carried out between 1982 and 1985 in Japan. A simple Weibull distribution function fitted well as a model. The mode of ATL onset was log‐linear in this model and the curves for males and females overlapped completely. The presence of age‐dependent accumulation of leukemogenic events within human T‐cell leukemia virus type 1‐immortalized T cells was suggested prior to the development of ATL, and the approximate number of independent leukemogenic events in ATL is estimated to be five. This stochastic analysis supported a multi‐step carcinogenesis as an appropriate model for ATL.