Adult T-Cell Leukemia in a Liver Transplant Recipient That Did Not Progress after Onset of Graft Rejection

Suzuki, Shinsuke; Uozumi, Kimiharu; Maeda, Masahiko; Yamasuji, Yoshiko; Hashimoto, Shinichi; Komorizono, Yasuji; Owatari, Satsuki; Tokunaga, Masahito; Haraguchi, Kouichi; Arima, Naomichi

doi:10.1532/ijh97.05158

Cited by 13 publications

(9 citation statements)

References 22 publications

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“…In a different rat model of HTLV-1 infection, oral HTLV-1 infection induced HTLV-1-specific T-cell tolerance and caused an elevation in the proviral load, while re-immunization of these rats resulted in the recovery of HTLV-1-specific T-cell responses and caused a reduction in the proviral loads (Hasegawa et al, 2003; Komori et al, 2006). Similarly, patients carrying HTLV-1 developed ATL after liver transplantation, when immunosuppressants were administered (Kawano et al, 2006; Suzuki et al, 2006). These findings suggest that HTLV-1-specific T-cells, especially Tax-specific CTLs, play important roles in anti-tumor and anti-viral surveillance in HTLV-1 infection.…”

Section: Different Htlv-1-specific T-cell Responses Between Diseasesmentioning

confidence: 99%

The roles of acquired and innate immunity in human T-cell leukemia virus type 1-mediated diseases

Kannagi¹,

Hasegawa²,

Takamori³

et al. 2012

Front. Microbio.

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Human T-cell leukemia virus type 1 (HTLV-1) causes adult T-cell leukemia (ATL) and HTLV-1-associated myelopathy/tropical spastic paraparesis in small subsets of HTLV-1 carriers. HTLV-1-specific T-cell responses play critical roles in anti-viral and anti-tumor host defense during HTLV-1 infections. Some HTLV-1 carriers exhibit selective loss or anergy of HTLV-1-specific T-cells at an asymptomatic stage. This is also observed in ATL patients and may therefore be an underlying risk factor of ATL in combination with elevated proviral loads. HTLV-1-specific T-cells often recognize the viral oncoprotein Tax, indicating expression of Tax protein in vivo, although levels of HTLV-1 gene expression are known to be very low. A type-I interferon (IFN) response can be induced by HTLV-1-infected cells and suppresses HTLV-1 expression in vitro, suggesting a role of type-I IFN response in viral suppression and pathogenesis in vivo. Both acquired and innate immune responses control the status of HTLV-1-infected cells and could be the important determinants in the development of HTLV-1-mediated malignant and inflammatory diseases.

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Section: Different Htlv-1-specific T-cell Responses Between Diseasesmentioning

confidence: 99%

The roles of acquired and innate immunity in human T-cell leukemia virus type 1-mediated diseases

Kannagi¹,

Hasegawa²,

Takamori³

et al. 2012

Front. Microbio.

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“…The few cases of ATLL arising after solid organ or allogeneic bone marrow transplantation albeit after a much longer period of latency further support this hypothesis although Tax expression was not determined. 10,11 In the case presented herein, it is tempting to speculate that the conditioning and the engraftment failure led to a much more severe immunosuppression, which allowed expression of the Tax protein. Given the clonal heterogeneity of ATLL cells, this could signify that either a clone could alter Tax expression depending on host's factors or that the emergence of a Tax-expressing subclone was favorised by the lack of a specific CTL response.…”

Section: Resultsmentioning

confidence: 91%

Tax unleashed: Fulminant Tax-positive Adult T-cell Leukemia/Lymphoma after failed allogeneic stem cell transplantation

Gourichon

Renand

Lepelletier

et al. 2009

Journal of Clinical Virology

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“…To date, there have only been five cases of HTLV1Yassociated disease reported after liver transplantation worldwide: two cases of HAM (34,56) and three of ATLL (57,58). It is noteworthy that all three cases of ATLL originated from the recipients' viral strain and not the living donor and that two of three of subsequent deaths were due to chronic rejection (57).…”

Section: Liver Transplantationmentioning

confidence: 99%

HTLV-1 in Solid-Organ Transplantation

Armstrong¹,

Corbett²,

Rowe³

et al. 2012

Transplantation

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Human T-cell lymphotrophic virus (HTLV)-1 has been reported after solid-organ transplantation, with a related fatal outcome in less than five cases. The natural history of HTLV-1 transmission from donor to recipient is unknown in this setting, because available screening platforms are suboptimal in low-prevalence areas and there is a lack of long-term follow-up. Minimizing organ wastage due to false-positive screening and avoiding donor-derived HTLV-associated diseases remain the goal. To date, only six HTLV-naive organ recipients from four donors (only one had confirmed HTLV) have developed HTLV-associated disease after transplantation. All of these cases were described in countries or from donors from HTLV-endemic regions. To the best of our knowledge, there have been no reported cases of donor-derived HTLV-1-associated death after organ transplantation in the world. Based on data from low-prevalence countries (Europe and the United States) and the current shortage of donor organs, it appears plausible to authorize the decision to transplant an organ without the prior knowledge of the donor's HTLV-1 status. Currently, it is not possible to exclude such transmission and recipients should be informed of the possible inadvertent transmission of this (and other) infections at the time of consent. In those cases where HTLV-1 transmission does occur, there may be a therapeutic window in which use of antiviral agents (i.e., zidovudine and raltegravir) may be of benefit. The development of national/international registries should allow a greater understanding of the extent and consequences of transmission risk and so allow a more evidence-based approach to management.

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Adult T-Cell Leukemia in a Liver Transplant Recipient That Did Not Progress after Onset of Graft Rejection

Cited by 13 publications

References 22 publications

The roles of acquired and innate immunity in human T-cell leukemia virus type 1-mediated diseases

The roles of acquired and innate immunity in human T-cell leukemia virus type 1-mediated diseases

Tax unleashed: Fulminant Tax-positive Adult T-cell Leukemia/Lymphoma after failed allogeneic stem cell transplantation

HTLV-1 in Solid-Organ Transplantation

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