Allogeneic hematopoietic stem cell transplantation for adult T-cell leukemia/lymphoma with HTLV-1-associated myelopathy.
Hikaru SakamotoHidehiro ItonagaYasushi SawayamaAzusa KojimaMasahiko ChiwataMachiko FujiokaHiroko KitanosonoMakiko HoraiTeiichiro MiyazakiHirokazu ShiraishiYoshitaka ImaizumiShinichiro YoshidaTomoko HataYoshihisa YamanoYasushi MiyazakiPublished in: International journal of hematology (2021)
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) can be curative for adult T-cell leukemia/lymphoma (ATL), but comorbidities increase transplant-related mortality. Here we report the outcome of allo-HSCT in a patient with ATL with human T-cell leukemia virus type I (HTLV-1)-associated myelopathy-tropical spastic paraparesis (HAM/TSP). A 48-year-old man was diagnosed with HAM/TSP and started prednisolone therapy. Ten years later, he developed lymphoma-type ATL. At the diagnosis of ATL, Osame's Motor Disability Score (OMDS) was 4. When prednisolone was gradually tapered and stopped following chemotherapy for ATL, HAM/TSP symptoms recurred (OMDS 7). Bone marrow transplantation from a human leukocyte antigen allele 8/8 matched unrelated donor was performed while ATL was in partial remission. Neutrophil engraftment with complete donor chimerism was achieved on day 19 after allo-HSCT. Mild gait improvement (OMDS 5) was observed on day 30. Although ATL relapsed on day 275, progression of HAM/TSP symptoms was not observed. Furthermore, there was no clear progression of HAM/TSP symptoms after donor lymphocyte infusions. The outcome of this case suggests that ATL patients with HAM/TSP tolerate allo-HSCT and donor lymphocyte infusions.
Keyphrases
- allogeneic hematopoietic stem cell transplantation
- acute myeloid leukemia
- bone marrow
- acute lymphoblastic leukemia
- diffuse large b cell lymphoma
- hematopoietic stem cell
- endothelial cells
- spinal cord
- peripheral blood
- mesenchymal stem cells
- sleep quality
- rheumatoid arthritis
- cerebral palsy
- risk factors
- coronary artery disease
- cardiovascular disease
- case report
- disease activity
- rectal cancer
- childhood cancer