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. 2018 Oct 8;8:14979. doi: 10.1038/s41598-018-33175-7

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© The Author(s) 2018

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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(A) Flow cytometry (FCM) profiles reflecting the changes in the PpIX/TSLC1 parameters during the onset and progression of ATL and HAM/TSP. Gradual changes in the PpIX/TSLC1 profiles, shifting from PpIX(−)/TSLC1(−) in (a) healthy PBMCs to (e–g) PpIX(−)/TSLC1(+) and PpIX(+)/TSLC1(+) in relation to the onset and/or progression from smoldering-, to chronic-, to acute-ATL. (b–d) AC PBMCs showing intermediate profiles. (h) HAM/TSP showing an increase in PpIX(+)^dim/TSLC1(−) fractions when compared to those in healthy PBMCs in addition to the PpIX(−)/TSLC1(−) fraction. (B) Leukemia Risk Index (LRI) and Inflammatory Reaction Index (IRI) changes during the onset and progression of ATL and HAM/TSP. LRI and IRI are defined as in Table 1. (a) Onset and progression-dependent increase of LRI as observed in ATL. The HAM/TSP specimen showed almost the same LRI value as healthy PBMCs. AC PBMCs were classified to 3 categories (low-, medium-, and high-risk) according to the LRI value, which corresponded to the typical FCM profiles in (A). (b) HAM/TSP showing high IRI values when compared to the other categories.