A PROPOSAL FOR SMOLDERING ADULT T-CELL LEUKEMIA - A CLINICOPATHOLOGIC STUDY OF 5 CASES

  • 1 January 1983
    • journal article
    • research article
    • Vol. 62  (4) , 758-766
Abstract
Five patients were observed with smoldering adult T-cell leukemia (ATL) who had skin lesions as premonitory symptoms. The illness developed slowly but flared up after seveal years. Skin lesions appeared in the form of erythema, papules or nodules. Infiltration of the skin by ATL cells was slight and the proportion of ATL cells in the peripheral blood was 0-2%. Serum lactate dehydrogenase (LDH) value was within normal range and was not associated with hypercalcemia; lymphadenopathy, hepatosplenomegaly and bone marrow infiltration were very slight. In most cases, hypergammaglobulinemia was seen, and, in 1 case, monoclonal hypergammaglobulinemia was observed. All 5 patients had lived in an area in which ATL was endemic and their anti-ATLA antibodies were positive: none had ever received a blood transfusion. One patient developed typical ATL after more than 13 yr of illness and died of renal insufficiency. Another patient developed typical ATL after 5 yr of illness and died of cryptococcus meningitis. Based on clinical and pathologic differences, these cases should be distingished from typical ATL cases for the purposes of prognosis and treatment.