Seko Y, Azuma M, Yagita H, Okumura K, Hirai H, Nagai R, Yazaki Y
Third Department of Internal Medicine, Faculty of Medicine, University of Tokyo.
Intern Med. 1995 Aug;34(8):782-4. doi: 10.2169/internalmedicine.34.782.
Here we report a rare case of T-cell prolymphocytic leukemia in whom leukemic killer cells, expressing a cytolytic factor perforin, infiltrated the heart. Perforin may have directly injured myocardial cells which showed marked expression of human leukocyte antigens (HLAs) and intercellular adhesion molecule-1 (ICAM-1) as well as costimulatory molecules B7 and B70, which are ligands for CD28 expressed on T-cells. In spite of chemotherapy against leukemic cells, this autoimmune process finally caused fatal congestive heart failure.
在此，我们报告一例罕见的T细胞原淋巴细胞白血病病例，其中表达溶细胞因子穿孔素的白血病杀伤细胞浸润了心脏。穿孔素可能直接损伤了心肌细胞，这些心肌细胞显示出人类白细胞抗原（HLA）、细胞间黏附分子-1（ICAM-1）以及共刺激分子B7和B70的显著表达，而B7和B70是T细胞上表达的CD28的配体。尽管针对白血病细胞进行了化疗，但这种自身免疫过程最终导致了致命的充血性心力衰竭。
