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.
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.
Rosenblatt
J D
JD
Department of Medicine, UCLA School of Medicine 90024-1678.
Giorgi
J V
JV
Golde
D W
DW
Ezra
J B
JB
Wu
A
A
Winberg
C D
CD
Glaspy
J
J
Wachsman
W
W
Chen
I S
IS
D000368:Aged; D000911:Antibodies, Monoclonal; D000945:Antigens, Differentiation, T-Lymphocyte / Q000032:analysis; D001402:B-Lymphocytes / Q000473:pathology*; D004262:DNA Restriction Enzymes; D004279:DNA, Viral / Q000032:analysis*; D017977:Deltaretrovirus / Q000235:genetics / Q000472:pathogenicity*; D006801:Humans; D007943:Leukemia, Hairy Cell / Q000382:microbiology* / Q000473:pathology; D008297:Male; D013601:T-Lymphocytes / Q000276:immunology / Q000382:microbiology* / Q000473:pathology; D050378:T-Lymphocytes, Regulatory / Q000382:microbiology / Q000473:pathology
D000911:Antibodies, Monoclonal; D000945:Antigens, Differentiation, T-Lymphocyte; D004279:DNA, Viral; D004262:DNA Restriction Enzymes