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Integrated human T-cell leukemia virus II genome in CD8 + T cells from a
patient with "atypical" hairy cell leukemia: evidence for distinct T and B
cell lymphoproliferative disorders
JD Rosenblatt, JV Giorgi, DW Golde, JB Ezra, A Wu, CD Winberg, J Glaspy, W Wachsman and IS Chen
Department of Medicine, UCLA School of Medicine 90024-1678.
We previously reported isolation of human T-cell leukemia virus II
(HTLV-II) from a second patient (N.R.A.) with atypical hairy cell leukemia.
Follow-up analysis of the characteristics of the patient's HTLV-II
infection over a 2-year period has revealed that the patient had two
coexistant lymphoproliferative disorders. Oligoclonally integrated HTLV-II
was detected in DNA extracted from the patient's peripheral blood
mononuclear cells on separate occasions greater than 1 year apart, similar
to integration of HTLV-I seen in adult T cell leukemia/lymphoma. Although
integrated provirus was readily detected, no HTLV-II viral RNA expression
was seen in fresh peripheral blood lymphoid cells. Although the patient's
peripheral blood consistently contained a majority of atypical lymphoid
cells with a T cell antigenic phenotype, he ultimately developed extensive
pleural, hepatic and soft tissue infiltration with malignant Tac+,
tartrate-resistant, acid phosphatase-positive (TRAP+) B cells of clonal
origin. To further characterize the role of HTLV-II, the patient's
peripheral blood mononuclear cells were fractionated into four enriched
subpopulations at autopsy. Oligoclonally integrated HTLV-II was detected in
DNA from a T cell-enriched fraction and a CD8+ T cell-enriched fraction,
but not in a CD4+ T cell-enriched fraction, a non-T cell fraction, or in B
cells obtained from the malignant pleural effusion. We conclude that the
patient harbored two distinct lymphoproliferative disorders, a TRAP+, Tac+
B cell malignancy consistent with hairy cell leukemia that did not contain
HTLV-II and a Tac-, CD8+ lymphoproliferative syndrome with oligoclonally
integrated HTLV-II.
Volume 71,
Issue 2,
pp. 363-369,
02/01/1988
Copyright © 1988 by The American Society of Hematology
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