Luisa Marcon, MD; Laurence A. Rubin, MD; Carole C. Kurman, BS; Mary Elizabeth Fritz, BS; Dan L. Longo, MD; Takashi Uchiyama, MD; Brenda K. Edwards, PhD; David L. Nelson, MD
Adult T-cell leukemia associated with human T-cell leukemia virus type I (HTLV-I) is characterized by a clonal expansion of a CD4-positive subset of T lymphocytes that constitutively express high numbers of interleukin-2 receptors and that frequently infiltrate the skin; osteolytic bone lesions; and hypercalcemia. Using an enzyme-linked immunosorbent assay (ELISA) test, we measured the level of soluble Tac peptide, one chain of the human interleukin-2 receptor, in the serum of 50 patients with adult T-cell leukemia (38 Japanese and 12 American patients), 8 patients with other hematologic malignancies, 8 asymptomatic HTLV-I-antibody-positive carriers, and 17 normal controls. The serum level of soluble Tac peptide (geometric mean U/mL, 95% CI) was elevated at presentation in all patients with adult T-cell leukemia (16 461; 819 to 330 896) when compared with normal controls (238; 112 to 502), patients with other hematologic malignancies (1302; 475 to 3569), and healthy HTLV-I antibody-positive carriers (490; 115 to 2086). The highest levels were seen in patients (n = 33) with acute (32 154; 2587 to 399 598) compared with chronic (5464; 661 to 45 156) disease (n = 14). Serum levels of Tac peptide also tended to be more elevated in patients with adult T-cell leukemia with hypercalcemia (32 072; 2461 to 417 908) compared with normocalcemic patients (13 885; 496 to 388 436). Serial measurements of soluble Tac peptide levels in serum were done in four patients with adult T-cell leukemia during chemotherapy and the levels reflected disease activity. These observations suggest that the measurement of soluble Tac peptide levels in patients with adult T-cell leukemia is useful as a noninvasive measure of tumor burden and will help in the diagnosis of the disease and management of these patients.
Luisa Marcon, Laurence A. Rubin, Carole C. Kurman, Mary Elizabeth Fritz, Dan L. Longo, Takashi Uchiyama, et al. Elevated Serum Levels of Soluble Tac Peptide in Adult T-Cell Leukemia: Correlation with Clinical Status during Chemotherapy. Ann Intern Med. 1988;109:274–279. doi: 10.7326/0003-4819-109-4-274
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Published: Ann Intern Med. 1988;109(4):274-279.
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