Epstein-Barr virus (EBV) genome carrying monoclonal B-cell lymphoma in a patient with adult T-cell leukemia-lymphoma.
A Japanese patient with adult T-cell leukemia-lymphoma (ATL) showed a disease progression from the smoldering type to the chronic type and finally to the acute type. The patient was variously treated, including 2'-deoxycoformycin, with some beneficial effects. During the chronic type he developed a composite lymphoma consisting of T-cell lymphoma (ATL) of medium-sized cells and B-cell lymphoma of diffuse large cell type. At that time, he also suffered from miliary tuberculosis and adenovirus type 11-induced hemorrhagic cystitis, indicating that he was in a marked immunodeficient state. Southern-blot analysis revealed that the two malignancies have distinct clonal origin on the basis of the following results: (1) clonally rearranged T-cell receptor beta-chain gene (TcR-beta gene) and germline configuration of immunoglobulin heavy chain gene (IgH gene) in ATL leukemic cells, (2) clonal rearrangement of IgH gene in lymphoma cells, indicating a monoclonal B-cell lymphoma, (3) monoclonal integration of HTLV-I provirus in ATL leukemic cells, (4) definite presence and monoclonal origin of EBV genome in lymphoma cells. This is the first report of secondary EBV genome carrying monoclonal B-cell lymphoma in an ATL patient. It is suggested that the immunodeficient state in the patient with ATL allows the emergence of EBV-related B-cell lymphoma.
Tobinai
K
K
Hematology-Oncology and Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan.
Ohtsu
T
T
Hayashi
M
M
Kinoshita
T
T
Matsuno
Y
Y
Mukai
K
K
Shimoyama
M
M
D000328:Adult; D015703:Antigens, CD / Q000032:analysis; D015139:Blotting, Southern; D003556:Cystitis / Q000209:etiology; D015333:Gene Rearrangement, beta-Chain T-Cell Antigen Receptor; D006684:HLA-DR Antigens / Q000032:analysis; D004854:Herpesvirus 4, Human / Q000235:genetics*; D015368:Human T-lymphotropic virus 1 / Q000235:genetics; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D016130:Immunophenotyping; D015458:Leukemia, T-Cell / Q000150:complications / Q000188:drug therapy / Q000235:genetics* / Q000382:microbiology; D016393:Lymphoma, B-Cell / Q000150:complications / Q000235:genetics* / Q000382:microbiology; D016399:Lymphoma, T-Cell / Q000150:complications / Q000188:drug therapy / Q000235:genetics*; D008297:Male; D016609:Neoplasms, Second Primary; D015649:Pentostatin / Q000627:therapeutic use; D016271:Proto-Oncogene Proteins c-myc / Q000235:genetics; D011533:Proviruses / Q000235:genetics; D014376:Tuberculosis / Q000209:etiology
D015703:Antigens, CD; D006684:HLA-DR Antigens; D007143:Immunoglobulin Heavy Chains; D016271:Proto-Oncogene Proteins c-myc; D015649:Pentostatin