Adult T-cell leukemia development from a human T-cell leukemia virus type I carrier after a living-donor liver transplantation
Adult T-cell leukemia development from a human T-cell leukemia virus type I carrier after a living-donor liver transplantation
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DOI：
10.1097/01.tp.0000235186.30113.c7
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发表时间：
2006-09-27
期刊：
影响因子：
6.2
通讯作者：
Harada, Mine
中科院分区：
文献类型：
--
作者：
Kawano, Noriaki;Shimoda, Kazuya;Harada, Mine
成人T细胞白血病（ATL）在人T细胞白血病病毒I型（HTLV-1）载体中发展。器官移植后免疫抑制治疗期间恶性肿瘤的发展是晚期致命并发症之一。我们描述了164例接受免疫抑制治疗的活体肝移植受者中8例HTLV-1携带者的三例ATL的发展。所有3例患者均使用他克莫司进行免疫抑制。急性型ATL是在活体肝移植后6、9和25个月诊断的，基于表现出“花状”核的CD 4 +25+淋巴细胞数量的增加和乳酸脱氢酶的升高。Southern印迹分析显示ATL细胞在外周血中呈克隆性增殖。ATL细胞来源于受体，如使用性染色体标记的荧光原位杂交分析所示。我们的观察结果表明，免疫抑制治疗，以防止移植排斥反应后，活体肝移植可能会导致ATL的发展HTLV-I载体。
Adult T-cell leukemia (ATL) develops in a human T-cell leukemia virus type I (HTLV-1) carrier. The development of malignancy during immunosuppressive treatment following organ transplantation is one of the late fatal complications. We describe the development of three cases of ATL in eight HTLV-1 carriers within 164 living-donor liver transplant recipients undergoing immunosuppressive treatment. All three cases were immunosuppressed with tacrolimus. Acute-type ATL was diagnosed at 6, 9, and 25 months after living-donor liver transplantation, based on increased numbers of CD4+25+ lymphocytes exhibiting "flower-like" nuclei, and the elevation of lactate dehydrogenase. Southern blot analysis demonstrated the clonal proliferation of ATL cells in peripheral blood. The ATL cells originated from the recipient, as demonstrated by fluorescence in situ hybridization analysis using sex chromosomal markers. Our observations suggest that immunosuppressive treatment for the prevention of graft rejection after living-donor liver transplantation may induce the development of ATL in an HTLV-I carrier.