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Development of adult T-cell leukemia in donor-derived human T-cell leukemia virus type I-infected T cells after allogeneic bone marrow transplantation

Leukemia volume 21, pages 1594–1596 (2007)Cite this article

Recently, we reported the first case of donor-derived adult T-cell leukemia (ATL) after allogeneic stem cell transplantation (SCT) from a human T-cell leukemia virus type I (HTLV-I)-seropositive donor.1 Southern blot analysis showed no significant clonal proliferation of HTLV-I-infected cells in the donor, and it remained unclear whether donor-derived ATL cells originated from T cells that were infected with HTLV-I in the donor. HTLV-I provirus load – the percentage of HTLV-I-infected cells among peripheral blood mononuclear cells (PBMCs) – was 1.3% in the donor, as most lymphocytes in asymptomatic carriers are not infected with HTLV-I. Accordingly, the donor-derived ATL may have developed in T cells that were newly infected with HTLV-I in the recipient after SCT.2 As a follow-up to our earlier report, we have now demonstrated, using tumor-specific polymerase chain reaction (PCR) methods, that the HTLV-I-infected clone, which is identical to the donor-derived ATL cells, is present among PBMCs of the donor, indicating that the donor-derived ATL cells were infected with HTLV-I in the donor before SCT. The host immune-suppressive conditions involved in the development of donor-derived ATL, based on the expression of tax gene transcripts in the donor-derived ATL cells, are described below.

A 44-year-old Japanese man with refractory lymphoma-type ATL underwent SCT from his human leukocyte antigen (HLA)-identical, 40-year-old brother with HTLV-I infection in February 2004. The original tumor in the right side of the neck disappeared after SCT, but resumed growth 2 months later. After localized irradiation of 3060 cGy and rapid reduction of immunosuppressive agents, including cyclosporine and prednisone, the tumor once again disappeared. In July 2004, the clinical features of the recipient fulfilled the criteria of acute-type ATL, and the origin of the ATL cells was confirmed to be donor-derived based on the donor–recipient chimerism status determined by PCR studies using fluorescent primers flanking an informative microsatellite region.1 In December 2006, the donor was still healthy.

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Acknowledgements

This work was supported by a Grant-in-Aid for Scientific Research from the Ministry of Education, Science, Sports and Culture of Japan (M.M.) and a grant for an anticancer project from the Ministry of Health, Welfare and Labour of Japan (MM).

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Authors and Affiliations

  1. Department of Medicine, National Hospital Organization Osaka Minami Medical Center, Osaka, Japan

    H Tamaki, A Kikuchi, T Yamagami & T Soma

  2. Laboratory of Virus Immunology, Institute for Virus Research, Kyoto University, Kyoto, Japan

    Y Taniguchi & M Matsuoka

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  1. H Tamaki
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Correspondence to H Tamaki.

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Tamaki, H., Taniguchi, Y., Kikuchi, A. et al. Development of adult T-cell leukemia in donor-derived human T-cell leukemia virus type I-infected T cells after allogeneic bone marrow transplantation. Leukemia 21, 1594–1596 (2007). https://doi.org/10.1038/sj.leu.2404697

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