ACUTE MYELOBLASTIC-LEUKEMIA ASSOCIATED WITH AN INTERMEDIATE STATE BETWEEN THE HEALTHY CARRIER STATE AND ADULT T-CELL LEUKEMIA

This report describes an intermediate state between the human T-cell l ymphotropic virus type I (HTLV-I) healthy carrier and adult T-cell Leu kemia (ATL) who developed acute myeloblastic leukemia (AML, FAB subtyp e M2). The polyclonal integration of HTLV-I proviral DNA was demonstra ted in the peripheral blood lymphoid cells, whereas AML cells had no H TLV-I proviral DNA. The patient achieved remission after combination c hemotherapy but cells with lobulated nuclei persist at a low level and the polyclonal integration of HTLV-I proviral DNA is still demonstrat ed. We suggest that the patients with the integration of HTLV-I provir al DNA might develop secondary neoplasms more frequently than healthy carriers and this case stresses the need to exercise caution with thes e patients. The relationship between HTLV-I and AML is briefly discuss ed.