The following case is that of a patient seen several years ago at the National Cancer Institute-Veterans Administration Oncology Branch.
A 28-year-old black male presented in May 1978 having been previously diagnosed with what was thought to be cutaneous T-cell lymphoma (CTCL). Skin nodules had erupted over this patient's body beginning in July 1977. Prior to this problem he had no known immune disorders, no history of exposure to carcinogenic substances, and no family history of leukemia or lymphoma. Cells were examined from his peripheral blood in addition to lymph node, skin, and metatarsal bone biopsies with the finding of malignant convoluted T cells. From tumor cells obtained from the lymph node biopsy, the HUT-102 T-lymphoblast cell line was established. The cell line would be the first of human origin to yield type C retrovirus particles [ 11.
Following treatment with combination chemotherapy and whole-body electron beam radiation, a complete remission was attained. Unfortunately, this was short lived, and in January 1979 the patient suffered a widespread systemic recurrence. Again, complete remission was achieved with a chemotherapeutic combination of etoposide, cyclophosphamide, hydroxydaunamycin, and vincristine. This, too, was only temporary. In May 1979 the patient was admitted for pneumonia and quickly developed new central nervous system lesions and pulmonary infiltrates. He died in 1979. His case was subsequently recognized as the first documented United States case of adult T-cell leukemia (ATL) caused by the retrovirus HTLV-I [ 11.