Pulmonary complications in patients with adult T-cell leukemia

Yoshioka, Ritsuko; Yamaguchi, Kazunari; Yoshinaga, Takeshi; Takatsuki, Kiyoshi

doi:10.1002/1097-0142(19850515)55:10<2491::aid-cncr2820551030>3.0.co;2-i

Cited by 95 publications

(41 citation statements)

References 9 publications

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“…Life-threatening CMV disease has been reported to be uncommon, occurring in !1% of patients [2,9]. The exception has been for patients with T cell leukemia, in whom serious CMV disease, primarily pneumonia, has been found at autopsy in 17%-75% of cases [3,4,7].…”

Section: Discussionmentioning

confidence: 99%

Cytomegalovirus Pneumonia in Adults with Leukemia: An Emerging Problem

Nguyen¹,

Estey²,

Raad³

et al. 2001

Clinical Infectious Diseases

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Cytomegalovirus (CMV) pneumonia is reportedly unusual among adults with leukemia who have not undergone transplantation. To assess the frequency of CMV pneumonia and its outcome during the present time, we reviewed the experience of 2136 hospitalized adults with leukemia. Sixty-one patients (2.9%) had CMV pneumonia diagnosed. The frequency doubled from 1.4% in 1992--1994 to 2.8% in 1995--1997 (P<.05). Fifty-four patients (89%) had received treatment with an immunosuppressive chemotherapeutic regimen that contained fludarabine (n=37), high-dose cytoxan (n=17), or both (n=10), and 15 patients (25%) had received granulocyte transfusions that were stimulated with hematopoietic growth factors from unscreened donors. The overall CMV pneumonia--associated mortality rate was 57%. Among autopsied patients who had leukemia, the frequency of CMV pneumonia increased from 0%, 2.3%, and 0% in 1992, 1993, and 1994, respectively, to 4.6%, 6.5%, and 16% in 1995, 1996, and 1997, respectively (P<.05). CMV has emerged as an important cause of life-threatening pneumonia in adults with leukemia who have received potent immunosuppressive therapies and stimulated granulocyte transfusions from unscreened donors.

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Section: Discussionmentioning

confidence: 99%

Cytomegalovirus Pneumonia in Adults with Leukemia: An Emerging Problem

Nguyen¹,

Estey²,

Raad³

et al. 2001

Clinical Infectious Diseases

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“…opportunistic infection, and exhibit the highest frequency compared with malignant lymphoma and acute leukemias (35). Recent studies using bronchoalveolar lavage (BAL) have demonstrated that HAM/TSP is also frequently associated with T-lymphocyte alveolitis (2, 27,28,32), and that soluble IL-2R (sIL-2R) levels in BAL fluid (BALF) are markedly elevated in these patients (28 analyzed on a FACScan flow cytometer (Becton Dickinson, FAGS Division).…”

mentioning

confidence: 99%

Increase in T‐Cells Bearing CD25 in Bronchoalveolar Lavage Fluid from HAM/TSP Patients and HTLV‐I Carriers

Mukae

Kohno

Morikawa

et al. 1994

Microbiology and Immunology

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To determine the immunologic characteristics of T-cells in local pulmonary lesions of human T-cell lymphotropic virus type I (HTLV-I) carriers, we investigated lymphocyte surface markers in peripheral blood and bronchoalveolar lavage fluid (BALF) of 38 HTLV-I carriers, 8 HTLV-I associated myelopathy/tropical spastic paraparesis (HAM/TSP) patients, 44 HTLV-I seronegative patients with pulmonary diseases and 7 healthy volunteers using two-color flow cytometric analysis. In peripheral blood, activated T-cells, CD4+HLA-DR +, CD8 +HLA-DR + and CD3+ CD25 +, and CD4+ CD29 + cells increased significantly in carriers and HAM/TSP patients compared with healthy volunteers and seronegative patients. In BALF, T-cells, especially CD25 + cells, increased significantly in carriers and HAM/TSP patients, compared with healthy volunteers and seronegative patients. These findings indicated that T-cells in the lungs, as well as in peripheral blood, are activated in carriers and HAM/TSP patients. Interestingly, there was dissociation between expression of CD3 + CD25 + cells in BALF and peripheral blood from these patients. These results suggest that T-cells activated probably by HTLV-I accumulate in the lungs in some carriers and HAM/TSP patients, and HTLV-I may be involved in the immunologic dysfunction in the lungs of these patients. However, we did not find any correlation between the degree of clinical features and the elevation of CD3 + CD25+ cells in BALF, or its characteristic features on chest roentgenograms.

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“…In most of the reported cases, the diagnosis was madeby postmortempathology without clinical or roentgenologic evidence of disease. However, bone scan using technetium-99m phosphates and transbroncheal lung biopsy provide important information for early detection of metastatic calcification (6,8,9,18,19,34,35).…”

Section: Discussionmentioning

confidence: 99%

Adult T-cell Leukemia with Hypercalcemia-induced Metastatic Calcification in the Lungs Due to Production of Parathyroid Hormone-related Protein.

et al. 2001

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A 60-year-old manwas diagnosed as adult T-cell leukemia with severe hypercalcemia because of production of parathyroid hormone-related protein. After admission, the patient had respiratory insufficiency with an infiltrative shadow in his lungs suggestive of pneumonia. However, neither improvement in respiratory function nor disappearance of the abnormal chest shadowwas observed with administration of various antibiotics. Anautopsy demonstrated the chest shadow had been caused by metastatic calcification associated with hypercalcemia due to production of parathyroid hormone-related protein. The possibility of metastatic calcification should be considered in patients with adult T-cell leukemia and hypercalcemia who have an abnormal chest shadow. (Internal Medicine 40: 409-413, 2001)

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Pulmonary complications in patients with adult T-cell leukemia

Cited by 95 publications

References 9 publications

Cytomegalovirus Pneumonia in Adults with Leukemia: An Emerging Problem

Cytomegalovirus Pneumonia in Adults with Leukemia: An Emerging Problem

Increase in T‐Cells Bearing CD25 in Bronchoalveolar Lavage Fluid from HAM/TSP Patients and HTLV‐I Carriers

Adult T-cell Leukemia with Hypercalcemia-induced Metastatic Calcification in the Lungs Due to Production of Parathyroid Hormone-related Protein.

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