Suzuki M, Uno H, Kiyomizu A, Kubuki Y, Yamashita K, Maeda K, Matsuoka H, Tsuda K, Tsubouchi H
Second Department of Internal Medicine, Miyazaki Medical School, Japan.
Acta Haematol. 1995;93(1):40-5. doi: 10.1159/000204089.
A patient with acute adult T-cell leukemia (ATL) in whom spontaneous remission was observed without any specific treatment having been given is described. The abnormal cell phenotype was CD4+, CD45RO+ and CD8-. As the number of abnormal cells decreased, CD4+ cell count decreased and CD8+ cells and CD45RA+ cells increased to normal levels (45 and 77%, respectively). Further, the number of cells with CD45RO antigen of intermediate fluorescence intensity increased. Five months after admission, we assessed the patient as being in a state of complete clinical remission; no abnormal cells were detected in peripheral blood, lymph node enlargement had disappeared and the serum chemistry was normal. When the abnormal cells in peripheral blood had disappeared, Southern blot analysis for HTLV-I proviral DNA still revealed a weak monoclonal band with EcoRI digestion, and HTLV-I proviral DNA was detected by polymerase chain reaction analysis. Thus, it appeared that very few abnormal cells persisted although the laboratory findings for ATL were normal. Our case could contribute to the understanding of the mechanism that underlies spontaneous remission in ATL.
本文描述了一名急性成人T细胞白血病（ATL）患者，该患者未经任何特殊治疗即出现自发缓解。异常细胞表型为CD4+、CD45RO+和CD8-。随着异常细胞数量减少，CD4+细胞计数下降，CD8+细胞和CD45RA+细胞增加至正常水平（分别为45%和77%）。此外，具有中等荧光强度CD45RO抗原的细胞数量增加。入院五个月后，我们评估该患者处于完全临床缓解状态；外周血未检测到异常细胞，淋巴结肿大消失，血清化学指标正常。当外周血中的异常细胞消失时，针对HTLV-I前病毒DNA的Southern印迹分析经EcoRI酶切仍显示出一条微弱的单克隆条带，且通过聚合酶链反应分析检测到HTLV-I前病毒DNA。因此，尽管ATL的实验室检查结果正常，但似乎仍有极少数异常细胞持续存在。我们的病例可能有助于理解ATL自发缓解的潜在机制。
