title: [A case of adult T cell leukemia treated with a new chemotherapeutic agent, KM2210].
abstract: A 58-year-old man, born in Nagasaki prefecture, was admitted to our hospital because of anorexia and general fatigue on November 22, 1984. Hepatosplenomegaly was found without skin eruption. The blood examination on admission revealed leukocytosis (50,800/microliter) and atypical lymphocytes with hyperlobulated nuclei. He had hypercalcemia, and hepatic and renal damage. A diagnosis of adult T cell leukemia (ATL) in the acute stage was made. Treatment with KM2210, a conjugate of chlorambucil and estradiol, was started, and his peripheral leukocytes decreased gradually reaching, 19,700/microliter by the end of this medication. His leukocyte count continued to decrease after discontinuation of KM2210 and reached a nadir of 4,700/microliter. Hepatosplenomegaly and hypercalcemia also improved. About one month later, recurrence of the disease occurred and he was again treated with KM2210. Although the second course of the KM2210 therapy was also successful in relieving hepatosplenomegaly and leukocytosis, it proved impossible to ameliorate his poor condition and he died of DIC. Our case suggests that KM2210 has a remarkable cytotoxic effect against ATL cells even in the acute stage but the optimal schedule of treatment with this new drug should be established in order to obtain more satisfactory therapeutic results.
mesh_terms: D000956:Antigens, Viral / Q000032:analysis; D002699:Chlorambucil / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006800:Deltaretrovirus Infections / Q000188:drug therapy* / Q000276:immunology; D004958:Estradiol / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015488:HIV Antigens; D006801:Humans; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged
chemical_list: D000956:Antigens, Viral; D015488:HIV Antigens; D002699:Chlorambucil; D004958:Estradiol; C036613:bestrabucil