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

自20世纪70年代口服光活性药物8-甲氧基补骨脂素（8-MOP）和暴露于高强度离子波紫外线系统导致能量性牛皮癣完全清除以来，补骨脂素和长波紫外线（PUVA）治疗已成为皮肤病治疗的常规形式，包括皮肤t细胞淋巴瘤（CTCL）。Edelson等人开发了体外光化学疗法（photoheresis）技术，即用PUVA处理欺凌涂层，然后将其交还给患者。在白血病皮肤t细胞淋巴瘤患者中，这种疗法试图改善疾病。我们已经尝试将这种疗法应用于某些成人t细胞白血病（ATL）患者，这在日本西南岛屿和加勒比盆地经常遇到。并以转化的CD4阳性细胞增殖为特征。这种疾病有时会浸润皮肤，类似于CTCL。ATL患者进展为hi、h白细胞计数、高钙血症、肝脾测量、aly和血清乳酸脱氢酶（LDH）水平升高。ATL的诊断非常糟糕，我们迫切需要新的治疗方法。我们将光变术应用于进行性系统性硬化症（PSS）患者，PSS是一种由活化的单核细胞引起的全身性疾病，其特征是皮肤和内脏中胶原沉积过多，并与自身免疫现象的表达相关。我们在此报告ATL患者和PSS患者，评估，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.