Anti-ATLA (Antibody to the Adult T-Cell Leukemia Cell-Associated Antigen)-Positive Hematologic Malignancies in the Kanto District

Abstract

Serum or plasma specimens from 278 patients having various hematologic malignancies or some other diseases were screened for reactivity with adult T-cell leukemia cell-associated antigen (ATLA). Antibodies against ATLA in cultured MT-1 cells, a line derived from adult T-cell leukemia (ATL), were found in 18 (6.5%) of the total 278 patients, but in 10 (34.5%) of 29 patients born in the ATL-endemic area. The antibodies were also detected in eight (80%) of 10 patients with ATL or adult T-cell leukemia/lymphoma (ATLL), and most of them were born in the ATL-endemic area. The anti bodies were detected in only eight (3.2%) of 249 patients who were born in an ATL nonendemic area, but six of the eight patients were ones with acute leukemia, and they were found to have had massive blood transfusions in cluding platelet or granulocyte transfusions. Generally, the patients who received transfusions were found to have a higher incidence of anti-ATLA than those without transfusions. In particular, in acute leukemia in an ATL-nonendemic area, the antibodies were detected in six (21.4%) of the 28 patients who had previous transfusions, but in none of the 16 not given transfusions. Further more, ATLA reactivity of the sera from the two patients was found to change from negative to positive in one to three months. During that period, both patients had massive platelet or granulocyte transfusions. These results not only confirm Hinuma's initial report on anti-ATLA, but also indicate the rare existence of anti-ATLA-negative patients who have ATL or ATLL. These facts also suggest that massive blood transfusions are one of the possible causes of the generation of anti-ATLA in the patients. However, direct evidence to prove this possibility must be sought.