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Kawamata T, Ohno N, Sato K, et al. A case of post-transplant adult T-cell leukemia/lymphoma presenting myelopathy similar to but distinct from human T-cell leukemia virus type I (HTLV- I)-associated myelopathy. Springerplus. 2014;3:581doi: 10.1186/2193-1801-3-581.
Kawamata, T., Ohno, N., Sato, K., Kobayashi, M., Jo, N., Yuji, K., Tanosaki, R., Yamano, Y., Tojo, A., & Uchimaru, K. (2014). A case of post-transplant adult T-cell leukemia/lymphoma presenting myelopathy similar to but distinct from human T-cell leukemia virus type I (HTLV- I)-associated myelopathy. SpringerPlus, 3581. https://doi.org/10.1186/2193-1801-3-581
Kawamata, Toyotaka, et al. "A case of post-transplant adult T-cell leukemia/lymphoma presenting myelopathy similar to but distinct from human T-cell leukemia virus type I (HTLV- I)-associated myelopathy." SpringerPlus vol. 3 (2014): 581. doi: https://doi.org/10.1186/2193-1801-3-581
Kawamata T, Ohno N, Sato K, Kobayashi M, Jo N, Yuji K, Tanosaki R, Yamano Y, Tojo A, Uchimaru K. A case of post-transplant adult T-cell leukemia/lymphoma presenting myelopathy similar to but distinct from human T-cell leukemia virus type I (HTLV- I)-associated myelopathy. Springerplus. 2014 Oct 04;3:581. doi: 10.1186/2193-1801-3-581. eCollection 2014. PMID: 25332881; PMCID: PMC4197197.
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Springerplus. 2014 Oct 04;3:581. doi: 10.1186/2193-1801-3-581. eCollection 2014.

A case of post-transplant adult T-cell leukemia/lymphoma presenting myelopathy similar to but distinct from human T-cell leukemia virus type I (HTLV- I)-associated myelopathy.

SpringerPlus

Toyotaka Kawamata, Nobuhiro Ohno, Kota Sato, Masayuki Kobayashi, Norihide Jo, Koichiro Yuji, Ryuji Tanosaki, Yoshihisa Yamano, Arinobu Tojo, Kaoru Uchimaru

Affiliations

  1. Department of Hematology/Oncology, Research Hospital, The Institute of Medical Science, the University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, 108-8639 Japan.
  2. Department of Hematology/Oncology, Research Hospital, The Institute of Medical Science, the University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, 108-8639 Japan ; Division of Molecular Therapy, Department of The advanced Clinical Research Center, The Institute of Medical Science, the University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, 108-8639 Japan.
  3. Department of Blood Transfusion and Cellular Therapy, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045 Japan.
  4. Department of Rare Diseases Research, Institute of Medical Science, St. Marianna University Graduate School of Medicine, Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8512 Japan.

PMID: 25332881 PMCID: PMC4197197 DOI: 10.1186/2193-1801-3-581

Abstract

INTRODUCTION: Adult T-cell leukemia/lymphoma (ATL) responds poorly to conventional chemotherapy, but allogeneic stem cell transplantation (allo-SCT) may improve disease prognosis. Herein, we report a female patient with human T-cell leukemia virus type I (HTLV-I)-associated myelopathy (HAM)-like myelopathy following allo-SCT for ATL.

CASE REPORT: She developed crural paresis 14 months after allo-SCT. Initially, she was diagnosed with central nervous system (CNS) relapse of ATL and treated with intrathecal injection and whole brain and spine irradiation. Her symptoms recurred 5 months later, when a cerebrospinal fluid (CSF) specimen showed increased CD4 + CXCR3 + CCR4+ cell numbers and levels of neopterin and CXCL10 (IP-10).

DISCUSSION: These results suggest the possible involvement of a certain immunological mechanism such as HAM in her symptoms, irrespective of the lack of anti-HTLV-I antibody in her CSF. Because a definitive diagnosis of CNS manifestation of ATL is sometimes difficult, multi-modal laboratory data are required for differential diagnosis.

Keywords: Adult T-cell leukemia/lymphoma; CXCL10 (IP-10); HTLV-I-associated myelopathy (HAM); Neopterin; Post-transplant myelopathy

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