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We previously reported that the cell adhesion molecule 1 ( CADM 1) versus  CD 7 plot in flow cytometry reflects disease progression in human T‐cell leukemia virus type 1 ( HTLV ‐1) infection. In  CD 4 +  cells from peripheral blood,  CADM 1 −  CD 7 +  (P),  CADM 1 +  CD 7 dim  (D) and  CADM 1 +  CD 7 −  (N) subpopulations are observed. The D and N subpopulations increase as asymptomatic  HTLV ‐1 carriers ( AC ) progress to indolent adult T‐cell leukemia‐lymphoma ( ATL ) and the N subpopulation then expands in aggressive  ATL . In the present study we examined whether the analysis can estimate the risk of developing  ATL  in advanced  AC . Peripheral blood samples from  AC  ( N  = 41) and indolent  ATL  patients ( N  = 19) were analyzed by flow cytometry using the  CADM 1 versus  CD 7 plot for  CD 4 +  cells and inverse long  PCR  (clonality analysis) of  FACS ‐sorted subpopulations. Almost all  AC  with a high  HTLV ‐1 proviral load (>4 copies/100 cells) had a  CADM 1 +  (D + N) frequency of >10%.  AC  with 25% <  CADM 1 +  ≤ 50% contained expanded clones similar to smoldering‐type  ATL . In many patients in the 25% <  CADM 1 +  ≤ 50% group, the proportion of abnormal lymphocytes was distributed around the 5% line, which divides  AC  and smoldering‐type  ATL  in Shimoyama's classification. In conclusion, the  CADM 1 versus  CD 7 plot is useful for selection of putative high‐risk  AC . The characteristics of some  AC  and smoldering  ATL  are said to be similar; however, long‐term follow up is required and the clinical outcome (e.g. rate of transformation) of these cases should be used to determine whether to include them in the same clinical category.

cancer science

Advanced human T‐cell leukemia virus type 1 carriers and early‐stage indolent adult T‐cell leukemia‐lymphoma are indistinguishable based on  CADM 1 positivity in flow cytometry