Long-term remission of chronic-type adult T-cell leukemia/lymphoma associated with Graves' disease treated with methimazole.
Shigeo Fuji, Kako Suzuki, Eri Watanabe et al.
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Case in brief
A 58-year-old woman diagnosed with chronic-type adult T-cell leukemia/lymphoma (ATL) in 2022 experienced disease progression alongside the development of Sjögren's syndrome and Graves' disease in 2023. Treatment with methimazole for hyperthyroidism led to a rapid decrease in abnormal lymphocyte counts and soluble interleukin-2 receptor levels. She has maintained long-term remission for over two years without cytotoxic chemotherapy.
What made this case unusual
The case highlights an unexpected and significant response of chronic-type ATL to methimazole, a treatment typically used for hyperthyroidism, suggesting a potential anti-ATL effect.
Diagnostic / clinical pearl
Clinicians should consider the potential impact of endocrine therapies on hematologic malignancies, as demonstrated by the remission of ATL following methimazole treatment.
Why it matters
This case emphasizes the need for further research into the endocrine-immune interactions in HTLV-1-associated malignancies and the potential role of antithyroid therapies in managing indolent ATL.