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
Externally publishedYes

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Adult T Cell Leukemia Lymphoma
Human T-lymphotropic virus 1
Spinal Cord Diseases
Stem Cell Transplantation
Transplants
Cerebrospinal Fluid
HTLV-I Antibodies
Central Nervous System
Tropical Spastic Paraparesis
Neopterin
Spinal Injections
Paresis
Spine
Differential Diagnosis
Cell Count
Recurrence
Drug Therapy
Brain

Keywords

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

ASJC Scopus subject areas

  • General

Cite this

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

In: SpringerPlus, Vol. 3, No. 1, 581, 30.12.2014.

Research output: Contribution to journalArticle

Kawamata, Toyotaka ; Ohno, Nobuhiro ; Sato, Kota ; Kobayashi, Masayuki ; Jo, Norihide ; Yuji, Koichiro ; Tanosaki, Ryuji ; Yamano, Yoshihisa ; Tojo, Arinobu ; Uchimaru, Kaoru. / 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. In: SpringerPlus. 2014 ; Vol. 3, No. 1.
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