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Interstitial lung disease with anti-melanoma differentiation-associated gene 5 antibody after allogeneic hematopoietic stem cell transplantation

Bone Marrow Transplantation volume 57, pages 1382–1388 (2022)Cite this article

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Abstract

Anti-melanoma differentiation-associated gene 5 (MDA5) antibody is one of auto-immune antibodies which is associated with a rare subtype of dermatomyositis (DM), and MDA5-DM is well-characterized by rapid progressive interstitial lung disease (ILD) which in part resembles pulmonary complications after allogeneic hematopoietic cell transplantation (allo-HCT). However, previous studies about anti-MDA5 antibody after allo-HCT were extremely limited. Here, we present 4 cases of ILD with anti-MDA5 antibody after allo-HCT. All of the cases showed rapidly progressive clinical course and 3 of 4 cases died despite intensive immunosuppressive therapies which included prednisolone, cyclophosphamide and calcineurin inhibitor. Additionally, 3 of 4 cases had tested positive for anti-MDA5 antibody by using cryopreserved plasma which were collected about 2–3 months before the diagnosis of MDA5-DM-ILD. It suggests that an inflammatory condition due to MDA5-DM-ILD might have sub-clinically occurred before the development of respiratory failure. The current cases suggest that the clinical feature was relatively similar to classical MDA5-DM-ILD, although it is difficult to distinguish MDA5-DM-ILD from chronic GVHD and other pulmonary complications after allo-HCT. Since clinical courses of MDA5-DM-ILD is considerably aggressive, it is important to discriminate MDA5-DM-ILD from other complications after allo-HCT.

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Fig. 1: Lung CT images.
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Please contact the corresponding author or Masaharu Tamaki (Division of hematology, Jichi Medical University Saitama Medical Center. E-mail: m.tamaki.221@gmail.com).

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Author notes

  1. These authors contributed equally: Masaharu Tamaki, Shimpei Matsumi.

Authors and Affiliations

  1. Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan

    Masaharu Tamaki, Shimpei Matsumi, Hideki Nakasone, Yuhei Nakamura, Masakatsu Kawamura, Shunto Kawamura, Junko Takeshita, Nozomu Yoshino, Yukiko Misaki, Kazuki Yoshimura, Ayumi Gomyo, Aki Tanihara, Yosuke Okada, Machiko Kusuda, Kazuaki Kameda, Shun-ichi Kimura, Shinichi Kako & Yoshinobu Kanda

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Contributions

MT and SM conceived the original idea and collected the data. MT wrote the manuscript. HN and YK advised on methods and wrote the manuscript. YN, MK, S.Kawamura, JT, NY, YM, KY, AG, AT, YO, MK and KK collected the data. SIK and SKako collected the data and contributed to critical revision of the manuscript. All authors approved the final version of the manuscript.

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Correspondence to Yoshinobu Kanda.

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Tamaki, M., Matsumi, S., Nakasone, H. et al. Interstitial lung disease with anti-melanoma differentiation-associated gene 5 antibody after allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 57, 1382–1388 (2022). https://doi.org/10.1038/s41409-022-01730-6

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