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Syngeneic hematopoietic stem cell transplantation from HTLV-1 seropositive twin for adult T-cell leukemia-lymphoma

Bone Marrow Transplantation volume 53, pages 654–656 (2018)Cite this article

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The human T-lymphotropic virus type I (HTLV-I) is a retrovirus that is usually transmitted vertically in endemic areas, which can lead to Adult T-cell leukemia-lymphoma (ATLL) in ~5% of carriers [1]. ATLL has four distinct clinical forms: the acute and lymphomatous are the most common and aggressive subtypes [2] with median overall survival (OS) of 8–12 months [3]. Outcomes remain poor despite chemotherapy [4], autologous [5], allogeneic [6] including cord blood [7] hematopoietic stem cell transplantation (HSCT). We present the first case of ATLL treated with syngeneic HSCT from HTLV-1 seropositive twin which remains in remission for more than 3 years post transplant.

A 48-year-old Ghanaian woman originally presented to an emergency room with lower abdominal pain, radiating to the back, and progressive back pain, at time where a CT scan of the abdomen and pelvis revealed numerous sclerotic vertebral lesions and a lytic left iliac wing lesion. An MRI of the spine showed diffuse bone marrow infiltration with intraspinal metastatic involvement at T9 with tumors surrounding the cord and presumed cord compression, as well as significant infiltration of the C4 vertebral body, narrowing of the spinal canal at T12 from tumor and involvement of the L3, L4, L5, and the sacrum. Given the concern for cord compression, she was treated with high-dose steroids, which were discontinued after patient remained without neurological deficits for a week. MRI of the brain showed no evidence of intracranial malignancy and a lumbar puncture was negative for malignant cells.

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Authors and Affiliations

  1. Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Oscar B. Lahoud, Alison J. Moskowitz, Steven M. Horwitz, Sergio A. Giralt & Parastoo B. Dahi

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  1. Oscar B. Lahoud
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  2. Alison J. Moskowitz
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  3. Steven M. Horwitz
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  4. Sergio A. Giralt
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  5. Parastoo B. Dahi
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Correspondence to Parastoo B. Dahi.

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Lahoud, O.B., Moskowitz, A.J., Horwitz, S.M. et al. Syngeneic hematopoietic stem cell transplantation from HTLV-1 seropositive twin for adult T-cell leukemia-lymphoma. Bone Marrow Transplant 53, 654–656 (2018). https://doi.org/10.1038/s41409-017-0086-0

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