TCRδ鎖遺伝子再構成を認めたAcute Unclassified Leukemiaの1例

伊藤 邦彦; 村頭 智; 奥 成顕; 武田 信英; 藤田 直久; 島崎 千尋; 中西 忍; 西尾 晃; 春山 春枝; 中川 雅夫; 堀池 重夫; 勇村 啓子; 河 敬世

doi:10.11406/rinketsu.30.2024

T cell Receptor δ Chain Gene Rearrangement in Acute Unclassified Leukemia

Kunihiko ITO, Satoshi MURAKAMI, Nariaki OKU, Nobuhide TAKEDA, Naohisa FUJITA, Chihiro SHIMAZAKI, Shinobu NAKANISHI, Akira NISHIO, Harue HARUYAMA, Masao NAKAGAWA, Shigeo HORIIKE, Keiko YUMURA, Keisei KAWA-HA

Author information

Kunihiko ITO
The Second Department of Internal Medicine, Kyoto Prefectural University of Medicine
Satoshi MURAKAMI
The Second Department of Internal Medicine, Kyoto Prefectural University of Medicine
Nariaki OKU
The Second Department of Internal Medicine, Kyoto Prefectural University of Medicine
Nobuhide TAKEDA
The Second Department of Internal Medicine, Kyoto Prefectural University of Medicine
Naohisa FUJITA
The Second Department of Internal Medicine, Kyoto Prefectural University of Medicine
Chihiro SHIMAZAKI
The Second Department of Internal Medicine, Kyoto Prefectural University of Medicine
Shinobu NAKANISHI
The Second Department of Internal Medicine, Kyoto Prefectural University of Medicine
Akira NISHIO
The Second Department of Internal Medicine, Kyoto Prefectural University of Medicine
Harue HARUYAMA
The Second Department of Internal Medicine, Kyoto Prefectural University of Medicine
Masao NAKAGAWA
The Second Department of Internal Medicine, Kyoto Prefectural University of Medicine
Shigeo HORIIKE
The Third Department of Internal Medicine, Kyoto Prefectural University of Medicine
Keiko YUMURA
Department of Pediatrics, Osaka University School of Medicine
Keisei KAWA-HA
Department of Pediatrics, Osaka University School of Medicine

Keywords: acute unclassified leukemia, T cell receptor δ gene rearrangement, cell lineage, monoclonality

JOURNAL RESTRICTED ACCESS

1989 Volume 30 Issue 11 Pages 2024-2028

DOI https://doi.org/10.11406/rinketsu.30.2024

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Abstract

A 31 year-old male who was treated with radiatoin under the diagnosis of malignant lymphoma was admitted to our hospital because of systemic erythema and tumor of bilateral upper arms in October, 1987.
Leucocyte count of peripheral blood showed 4,400/μl with 36% leukemic cells and bone marrow was hypercellular with 85.6% leukemic cells. Leukemic cells were negative for peroxidase reaction and lineage specific monoclonal antibodies such as CD3, CD4, CD8, CD10, CD19 and CD20. T cell receptor (TCR) δ gene was rearranged but TCRβ, TCRγ and immunoglobulin (Ig) genes were in germline configuration.
He was treated with combination regimen of doxorubicin, vindesine, prednisolone and L-asparaginase, and complete remission was obtained.
These observations suggest that TCR δ gene rearrangement is useful for determination of clonality in cases without rearrangements of the other TCR and Ig genes.

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