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Spontaneous regression in adult T-cell leukemia/lymphoma
Y Shimamoto1, M Kikuchi, N Funai
1Department of Internal Medicine, Saga Medical School, Japan.
Background:
Spontaneous regression of adult T-cell leukemia/lymphoma (ATL) is considered to be extremely unusual. Of the 82 patients with ATL who the authors saw between 1981 and 1991, spontaneous regression occurred in 3 (3.7%), 2 of whom were previously untreated and one who had been previously treated. Surgical excisional biopsy triggered the spontaneous regression in these patients.
Methods:
In two of these patients with spontaneous regression, gene analysis studies of human T-cell leukemia virus type I (HTLV-I) proviral DNA, and T-cell receptor (TCR) were carried out by Southern blot analysis in lymph node cells or peripheral lymphocytes before regression and after recurrence.
Results:
One patient exhibited monoclonal integration of HTLV-I proviral DNA and the rearranged band of the TCR-beta gene at the same positions both before regression and after recurrence. The other patient showed them at the different positions before regression and after recurrence.
Conclusions:
The authors' studies indicated heterogeneity in ATL patients with spontaneous regression. Temporary spontaneous regression could occur in typical ATL and might be associated with a longer survival time than that for prototypic ATL.