@article{oai:nagasaki-u.repo.nii.ac.jp:00016285,
 author = {Osaka, Akemi and Yanagihara, Katsunori and Yamada, Yasuaki and Hasegawa, Hiroo and Inokuchi, Naoko and Hayashi, Tomayoshi and Komoda, Minori and Nakamura, Shigeki and Aoyama, Muneo and Sawada, Takashi and Kamihira, Shimeru},
 issue = {2},
 journal = {The Tohoku Journal of Experimental Medicine},
 month = {Jun},
 note = {Patients with hematological malignancies frequently suffer from lung diseases as a complication. However, it is difficult to discriminate leukemic invasion into the lung from infectious pulmonary complications. The serum level of Krebs von den Lungen-6 (KL-6), which is a mucin-like glycoprotein, is increased in more than 70% of patients with interstitial pneumonia. Surfactant protein-D (SP-D) is produced mainly in the lung by alveolar type II and bronchiolar epithelial cells and is a useful serum marker for interstitial pneumonia. We therefore measured the levels of KL-6 and SP-D in sera from 128 patients (76 males and 52 females, mean age: 59 years) with hematological malignancies, including adult T-cell leukemia (ATL). Overall, the increase in KL-6 or SP-D, above each cut-off value (500 U/ml for KL-6 and 110 ng/ml for SP-D), was detected in 11 patients (8.6%) or 10 patients (7.8%), respectively. In contrast, among 67 ATL patients, 15 patients had high serum levels of KL-6 and/or SP-D; both were elevatedin 2 patients, only KL-6 was elevated in 6 patients and only SP-D was elevated in 7 patients. Thus, serum KL-6 and SP-D appear to be elevated in a mutually exclusive manner in ATL. Indeed, high serum levels of KL-6 were closely related to the stage of ATL, while the serum SP-D was elevated in ATL patients with pulmonary infection. In conclusion, the combined measurement of KL-6 and SP-D in ATL may become a useful means to discriminate leukemic pulmonary lesions from infectious pulmonary complications., The Tohoku Journal of Experimental Medicine, 218(2), pp.99-105},
 pages = {99--105},
 title = {Elevation of Serum KL-6 Glycoprotein or Surfactant Protein-D in Adult T-cell Leukemia with Distinct Pulmonary Complications},
 volume = {218},
 year = {2009}
}