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International Journal of Hematology
Published in: International Journal of Hematology 5/2021

01-05-2021 | Lymphoma | Case Report

Allogeneic hematopoietic stem cell transplantation for adult T-cell leukemia/lymphoma with HTLV-1-associated myelopathy

Authors: Hikaru Sakamoto, Hidehiro Itonaga, Yasushi Sawayama, Azusa Kojima, Masahiko Chiwata, Machiko Fujioka, Hiroko Kitanosono, Makiko Horai, Teiichiro Miyazaki, Hirokazu Shiraishi, Yoshitaka Imaizumi, Shinichiro Yoshida, Tomoko Hata, Yoshihisa Yamano, Yasushi Miyazaki

Published in: International Journal of Hematology | Issue 5/2021

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Abstract

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.
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Metadata
Title
Allogeneic hematopoietic stem cell transplantation for adult T-cell leukemia/lymphoma with HTLV-1-associated myelopathy
Authors
Hikaru Sakamoto
Hidehiro Itonaga
Yasushi Sawayama
Azusa Kojima
Masahiko Chiwata
Machiko Fujioka
Hiroko Kitanosono
Makiko Horai
Teiichiro Miyazaki
Hirokazu Shiraishi
Yoshitaka Imaizumi
Shinichiro Yoshida
Tomoko Hata
Yoshihisa Yamano
Yasushi Miyazaki
Publication date
01-05-2021
Publisher
Springer Singapore
Published in
International Journal of Hematology / Issue 5/2021
Print ISSN: 0925-5710
Electronic ISSN: 1865-3774
DOI
https://doi.org/10.1007/s12185-020-03075-6

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