title: Heterogeneity in clonal nature in the smoldering subtype of adult T-cell leukemia: continuity from carrier status to smoldering ATL.
abstract: To better understand indeterminate HTLV-1 carriers and smoldering (SM) subtype of adult T-cell leukemia (ATL), HTLV-1 proviral integrated status, proviral load (PVL) and ATL-related biomarkers were examined in 57 smoldering cases, including unusual carriers with a percentage of ATL-like cells. We found that according to Southern blot hybridization analytic features, 28 patients with SM ATL could be divided into 3 groups consisting of 16 (57.4%) patients with a monoclonal band, 6 (21.4%) with oligoclonal bands and the remaining 6 with smears. Although no clinical differences were observed among the 3 SM subtypes, HTLV-1-infected CD4 T-cell counts increased in order of poly-, oligo- and monoclonal subtypes. This trend began in the carrier stage and also was observed in PVL, CD25 and CCR4, indicating that a clone consisting of leukemic phenotypic cells was continuously growing. Moreover, the antigen modulation rates of CD26 and CD7 and the increasing rate of CD25 and CCR4 cells were closely correlated to growing clonal size, indicating that these markers had the possibility to predict a monoclonal band. In particular, CD26 or the ratio of CD26/CD25 had a validity differential for leukemic nature and predictive detection of clonal band. Conclusively, the present study shows that smoldering ATL is heterogeneous in the leukemogenic process, and the behavior of CD26 plays a central role in the evolution from early occult to overt smoldering ATL.
authors.affiliation: Central Diagnostic Laboratory of Nagasaki University Hospital, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan. kamihira@nagasaki-u.ac.jp
authors.forename: Shimeru
authors.initials: S
authors.lastname: Kamihira
authors.forename: Masako
authors.initials: M
authors.lastname: Iwanaga
authors.forename: Yuko
authors.initials: Y
authors.lastname: Doi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Sasaki
authors.forename: Sayaka
authors.initials: S
authors.lastname: Mori
authors.forename: Kazuto
authors.initials: K
authors.lastname: Tsurda
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nagai
authors.forename: Naoki
authors.initials: N
authors.lastname: Uno
authors.forename: Hiroo
authors.initials: H
authors.lastname: Hasegawa
authors.forename: Katsunori
authors.initials: K
authors.lastname: Yanagihara
authors.forename: Yoshitomo
authors.initials: Y
authors.lastname: Morinaga
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Tsukasaki
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Taniguchi
mesh_terms: D000328:Adult; D015703:Antigens, CD / Q000276:immunology; D015139:Blotting, Southern; D018819:Dipeptidyl Peptidase 4 / Q000276:immunology; D015490:HTLV-I Infections / Q000821:virology; D015368:Human T-lymphotropic virus 1 / Q000302:isolation & purification*; D006801:Humans; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000276:immunology / Q000473:pathology* / Q000821:virology*; D013601:T-Lymphocytes / Q000276:immunology / Q000473:pathology* / Q000821:virology*; D019562:Viral Load
chemical_list: D015703:Antigens, CD; D018819:Dipeptidyl Peptidase 4