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A proposal for smoldering adult T-cell leukemia: a clinicopathologic study
of five cases
K Yamaguchi, H Nishimura, H Kohrogi, M Jono, Y Miyamoto and K Takatsuki
We have observed five patients with smoldering adult T-cell leukemia (ATL)
who had skin lesions as premonitory symptoms. The illness developed slowly,
but flared up after several 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%.
The 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 one case, monoclonal
hypergammaglobulinemia was observed. All five 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, we
believe that these cases should be distinguished from typical ATL cases for
the purposes of prognosis and treatment.
Volume 62,
Issue 4,
pp. 758-766,
10/01/1983
Copyright © 1983 by The American Society of Hematology
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