Treatment of adult T cell leukemia and antoimmune diseases by extracorporeal photochemotherapy

自从光活性药物8-甲氧基补骨脂素（8-MOP）的口服治疗和暴露于高强度离子波紫外线系统的组合在20世纪70年代导致能量化银屑病的完全清除以来，补骨脂素和长波紫外线（PUVA）治疗已经成为皮肤病（包括皮肤T细胞淋巴瘤（CTCL））的皮肤病学治疗的常规形式。开发了体外光化学疗法（光化学疗法）技术，其中在将其返回患者之前，用PUVA处理被毛。在患有白血病皮肤T细胞淋巴瘤的患者中，这种疗法试图改善疾病。我们试图将这种疗法应用于某些患有成人T细胞白血病（ATL）的患者，该患者在日本西南部岛屿和加勒比海盆地经常遇到，其特征在于转化的CD 4阳性细胞的增殖。这种疾病有时浸润皮肤类似CTCL，和。患有ATL的患者进展为HI、HI白色血细胞计数、高钙血症、肝脾肿大、Aly和血清中乳酸脱氢酶（LDH）水平升高。ATL的预后非常差，我们迫切需要新的治疗方法，我们已经将单采术应用于患有进行性系统性硬化症（PSS）的患者，PSS是由活化的单核细胞引起的系统性疾病，其特征在于皮肤和内部的过度胶原沉积，与自身免疫现象的表达相关。本文报告对ATL和PSS患者的评价及治疗效果。

Since the combination of oral therapy of a photoactive drug, 8-methoxypsoralen (8-MOP), and exposure to a high-intensity, Ion, -wave ultraviolet-light system resulted in complete clearing of energized psoriasis in the 1970's, psoralen and long-wave ultraviolet li, ht (PUVA) therapy has become a routine form of dermatologic therapy for skin diseases including cutaneous T-cell lymphoma (CTCL).Edelson et al., developed the technique of extracorporeal photochemotherapy (photopheresis) in which the bully coat is treated with PUVA before it is retumed to the patient. In patients with leukemia cutaneous T-cell lymphoma, this therapy has attempted in improvement of the disease.We have attempted to apply this therapy to certain patients with adult T-cell leukemia (ATL), which is frequently encountered in the southwestern islands of Japan and the Caribbean basin, ; and characterized by the proliferation of transformed CD4 positive cells. This disease sometimes infiltrates the skin similarly to CTCL, and. patients with ATL progress to hi, h white blood cell counts, hypercalcemia, hepatosplenomec, aly, and elevated levels of lactic dehydroenase (LDH) in the serum. The Proo'nosis for 'ATL is extremely poor, and we are desperately in need of new therapies.We have applied photopheresis to patients with progressive systemic sclerosis (PSS), a systemic disease caused by activated mononuclear cells and characterized by excessive collagen deposition in the skin and internal or, ans associated with the expression of autoimmune phenomena. We report here on ATL patients and PSS patients, evaluation, the therapeutic effects.