OBSERVATION OF T-CELL SURFACE-ANTIGENS IN THE CLINICAL COURSE OF ADULT T-CELL LEUKEMIA - CASE-REPORT OF A SPONTANEOUS REMISSION

A patient with acute adult T-cell leukemia (ATL) in whom spontaneous r emission was observed without any specific treatment having been given is described. The abnormal cell phenotype was CD4+, CD45RO+ and CD8-. As the number of abnormal cells decreased, CD4+ cell count decreased and CD8+ cells and CD45RA+ cells increased to normal levels (45 and 77 %, respectively). Further, the number of cells with CD45RO antigen of intermediate fluorescence intensity increased. Five months after admis sion, me assessed the patient as being in a state of complete clinical remission; no abnormal cells were detected in peripheral blood, lymph node enlargement had disappeared and the serum chemistry was normal. When the abnormal cells in peripheral blood had disappeared, Southern blot analysis for HTLV-I proviral DNA still revealed a weak monoclonal band with EcoRI digestion, and HTLV-I proviral DNA was detected by po lymerase chain reaction analysis. Thus, it appeared that very few abno rmal cells persisted although the laboratory findings for ATL were nor mal. Our case could contribute to the understanding of the mechanism t hat underlies spontaneous remission in ATL.