Adult T-cell leukemia successfully treated with allogeneic bone marrow transplantation

Adult T-cell leukemia (ATL) is associated with human T-cell leukemia virus type 1 (HTLV-1) and is known to be a refractory disease of highly poor prog nosis. We describe a case of ATL treated with allogeneic bone marrow transp lantation (allo-BMT). The allo-BMT successfully induced complete remission in the patient. Currently, at 24 months post BMT, there has been no evidenc e of minimal residual disease (MRD) detected by polymerase chain reaction ( PCR) assay for the T-cell receptor gamma chain gene. By contrast, PCR analy sis demonstrated the reappearance of the cells harboring the integrations o f the HTLV-1 proviral DNA 9 months after the BMT. These findings may imply a reversion to the carrier state rather than the recurrence of the leukemia front the MRD. The clinical consequence of our case illustrates that allo- BMT is an effective therapy, at least for achieving longer disease-free sur vival in ATL. Int J Hematol. 2000;71:290-293 (C) 2000 The Japanese Society of Hematology.