A 24-year-old Japanese woman was admitted to our hospital in 1987 with a chief complaint of skin eruptions, and was diagnosed as having chronic ATLL. In 1993 the leucocyte count increased gradually to 126.0 x 10(9)/l with 91.5% abnormal lymphocytes expressing two different types of antigenicity, either CD+/CD8- or CD4-/CD8+. Monoclonal integration of human T-cell lymphotropic virus type-I proviral DNA was detected at different sites of the genomic DNA in each cell type. These studies clearly indicate that CD4+/CD8- and CD4-/CD8+ leukaemic cells originated from two independent clones.
"There are few reports of ATLL harbouring distinct clones (Tsukasaki et al, 1997; Shimamoto et al, 1993; Kondo et al, 1995; Shibata et al, 1995), but patient 3 is the first documented case of clonal change occurring during treatment . Fluctuation of the frequency of circulating clones was also observed in all other patients. "
[Show abstract][Hide abstract] ABSTRACT: Many adult T-cell leukaemia/lymphoma (ATLL) patients who respond to induction treatment, then relapse. Knowing the clonality pattern of residual tumourous clones during treatment could help understand disease evolution and aid therapeutic decisions. We developed a sensitive and semi-quantitative molecular analysis of these clones in ATLL patients. DNA samples from PBMCs derived from eight ATLL patients were studied over time by quadruplicate linker mediated PCR (LMPCR) amplification of HTLV-1 integration sites. Patients were treated with combination chemotherapy, zidovudine-interferon-alpha and/or by peripheral stem cell transplantation or allogeneic bone marrow transplantation. Persistence of tumourous clones at a high frequency (>1/300 PBMCs) was frequently observed, even in complete responders, and was invariably correlated with relapse and/or poor outcome. Fluctuation in the frequency of some tumourous clones was observed with evidence for clonal change under treatment in one patient, indicating that treatment of ATLL can result in the selection of resistant clones. Finally, allogeneic bone marrow transplantation (BMT) using an HTLV-1 infected sibling as donor was found to be associated with long-lasting disappearance of tumourous clones and a possible cure of the disease. Long-term persistent clonal expansion of circulating HTLV-1 bearing T cells which derived from the donor bone marrow was evidenced in this patient. In conclusion, variable success in treatment of ATLL is probably due to the clonal heterogeneity which results in the selection of resistant clones. Semi-quantitative assessment of residual disease (RD) through LMPCR may predict treatment failure. Accordingly, additional therapy may be tailored to the clonality pattern observed after first-line therapy.
British Journal of Haematology 07/1999; 105(3):743-51. DOI:10.1046/j.1365-2141.1999.01389.x · 4.71 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Typical adult T-cell leukaemia (ATL) cells have a CD4+ CD8- cell surface phenotype, but atypical phenotypes such as CD4+ CD8+ and CD4- CD8+ have also been reported. The CD8 molecule is composed of alpha and beta chains and commonly used monoclonal antibodies against CD8 molecule detect only CD8alpha. Since it has been reported that CD8alpha can be induced in mature CD4+ T cells by cell activation, but not CD8beta, we studied whether ATL cells which express CD8alpha may also express CD8beta. We found some cases of CD8alpha+ ATL were also positive for CD8beta. Furthermore, we experienced a case whose ATL cell surface phenotype changed from CD4+ CD8alpha+ CD8beta+ to CD4- CD8alpha+ CD8beta+ and finally to CD4+ CD8alpha- CD8beta-. Southern blot analysis revealed that the monoclonal integration of human T lymphotropic virus type I (HTLV-I) was identical throughout the course of the study, indicating that a single clone had demonstrated the alterations. These data suggest that peripheral CD4+ CD8+ ATL cells can express not only CD8alpha, but also CD8beta and that a single ATL cell clone has the potential to change its surface phenotype in vivo as well as in vitro.
British Journal of Haematology 08/1997; 98(1):151-6. DOI:10.1046/j.1365-2141.1997.1853002.x · 4.71 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The association of CD26/dipeptidyl peptidase IV (DPPIV) and human T lymphotropic virus type I (HTLV-I) was studied by two approaches. First, we examined the expression of CD26 in peripheral blood mononuclear cells (PBMC) from the patients with adult T cell leukemia/lymphoma (ATLL), an HTLV-I-related malignancy. The expression of CD26 on the surface of PBMC was decreased in all 20 patients with ATLL compared with those from normal individuals (P < 0.01) and the expression of the CD26 gene transcript was not detectable in seven out of eight patients with ATLL. Then we compared the quantity of viral DNA in CD26-negative (CD26-) and CD26-positive (CD26+) cells obtained from 17 HTLV-I healthy carries by using a polymerase chain reaction method. The CD26-cells had a higher copy number of viral DNA than CD26+ cells. These findings indicate that HTLV-I has in vivo tropism to CD26- cells, suggesting that some phenotypes of ATLL cells reflect the in vivo cellular tropism of HTLV-I.
Leukemia Research 04/1996; 20(4):357-63. DOI:10.1016/0145-2126(95)00159-X · 2.35 Impact Factor
Ann J Ligocki, Joseph R Brown, Jerry Y Niederkorn,
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