Abstract
This case report describes a follow-up of a male patient who overcame 2 episodes of crisis type of chronic ATL. The onset was at end of October 1991, and the treatment at the Kumamoto University Hospital with recombinant interleukin-1β (rIL-1β) began in June 1992 under the diagnosis of crisis type of chronic ATL. The patient reached complete remission (CR) 5 months after beginning treatment, and all laboratory test values normalized within 10 months. The CR state was maintained for 13 years without any treatment for ATL. However, in November 2007, red papules and nodules on the extremities as well as lung disorder recurred ; the condition was again diagnosed as a crisis type of chronic ATL. Combination therapy with low doses of oral Sobuzoxane + Etoposide was started in March, 2008. The treatment provided excellent results for the skin and lung conditions, leading to CR of the ATL after 6 months. The patient was in CR even 2 years later, when he died of multiorgan failure secondary to pyelonephritis. The reason for the effectiveness of his treatment is unknown, apart from the fact that rIL-1β treatment was chosen instead of chemotherapy. Moreover, ATL cells had infiltrated intracutaneously, and an evident granulomatous reaction was apparent in both pre-treatment biopsies performed in 1992 and 2008, which might be important points to consider.
