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

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

Research output: Contribution to journalArticle

3 Citations (Scopus)

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.

Original languageEnglish
Article number581
JournalSpringerPlus
Volume3
Issue number1
DOIs
Publication statusPublished - 2014 Dec 30

Keywords

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

ASJC Scopus subject areas

  • General

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