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Successful Treatment of Adult T‐cell Leukemia/Lymphoma with MACOP‐B, M‐FEPA and VEPP‐B Combination Chemotherapy
Author(s) -
Nagatani Tetsuo,
Miyazawa Megumi,
Matsuzaki Toshiko,
Iemoto Gaijiro,
Kim Shutaku,
Baba Naoko,
Miyakawa Kanata,
Miyamoto Hideaki,
Nakajima Hiroshi,
Hirai Yoshio
Publication year - 1993
Publication title -
the journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.9
H-Index - 65
eISSN - 1346-8138
pISSN - 0385-2407
DOI - 10.1111/j.1346-8138.1993.tb01351.x
Subject(s) - hepatosplenomegaly , cd5 , medicine , generalized lymphadenopathy , atypical lymphocyte , adult t cell leukemia/lymphoma , pathology , cd8 , lymph node , lymphoma , antibody , t cell leukemia , immunology , immune system , disease
A 45‐year‐old man was referred to our department in March of 1989. Physical examination showed erythroderma, palmo‐plantar hyperkeratosis, generalized lymphadenopathy, hepatosplenomegaly, and leukemic manifestation. The lymphocyte count in the peripheral blood before treatment was 1.7 × 10 4 cells/mm 3 . Atypical lymphocytes such as flower cells and lobulated cells were seen in the peripheral blood. A sample excised from a lymph node showed immunoblastic, pleomorphic T cells by a modified classification scheme of the Working Formulation. A high level of serum LDH was detected (2.1 times the upper normal limit). Anti HTLV‐1 antibody was also detected in the serum. The atypical lymphocytes were positive for CD3, CD4, CD5, CD7 and HLA‐DR, and negative for CD8. Thus, the clinical, pathologic and immunologic features were those of typical acute‐type ATL. The patient was treated with VEPA‐M for three months starting in March of 1989. Because of poor response, the patient was then treated with MACOP‐B, M‐FEPA, and VEPP‐B for about one year from June of 1989 and has been free of disease up to the time of writing, March of 1993.