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Inflammatory pseudotumor following cord blood transplantation for adult T-cell leukemia

Bone Marrow Transplantation volume 42, pages 493–494 (2008)Cite this article

Adult T-cell leukemia (ATL) is a human malignancy associated with human T-lymphotropic retrovirus type-1 and diagnosed based on clinicopathological findings and the presence of integrated human T-lymphotropic retrovirus type-1 provirus in the DNA of tumor cells.1 Despite recent progress in combination chemotherapy regimens, acute-type ATL usually has a poor prognosis.2 Allogeneic SCT is expected to be another therapeutic option for patients with ATL.3, 4 Recently, cord blood transplantation (CBT) has been used for adult patients with hematological malignancies as donor coordination is not necessary, and the incidence and severity of acute GVHD are lower than those for BMT.5 Inflammatory pseudotumor (IPT) is a rare tumor that can occur in various organs and tissues.6 Although its pathogenesis remains unclear, the terms inflammatory myofibroblastic tumor or inflammatory myofibrohistiocytic proliferation have been proposed as being more descriptive of IPT arising in the lung.7 IPT of different organs associated with hematopoietic SCT (HSCT), although rare, has also been reported.8 We describe a patient who developed a lung IPT after CBT. To the best of our knowledge, this report of lung IPT after CBT is also the first report of any IPT after CBT.

The causes of IPT are unknown; however, some authors believe that this tumor is a low-grade fibrosarcoma with inflammatory cells.6 IPT most commonly involves the lung and the orbit, but has been reported to occur in most sites in the body.6 The case described occurred in the lung. Although the relationship between IPT and HSCT is unclear, many factors are implicated. Infection, chemotherapy and radiotherapy have been conjectured as factors for IPT development.7, 10 All patients with IPT after HSCT have undergone high-dose chemotherapy and some also received TBI. For IPTs developing after HSCT, immunosuppression and GVHD are the two factors most likely to be associated.11, 12 In particular, in the first report of a lung IPT after HSCT, the patient had a lung infection prior to the development of IPT.12 However, our patients had no significant lung infection prior to the development of IPT. In addition, cord blood has been demonstrated to induce less GVHD in the setting of HLA-mismatched grafting. Indeed, our case did not suffer severe GVHD.

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Authors and Affiliations

  1. Division of Hematology, Kishiwada City Hospital, Kishiwada, Osaka, Japan

    S Nomura, K Ishii & M Shimizu

  2. Second Department of Internal Medicine, Kansai Medical University, Moriguchi, Osaka, Japan

    N Inami

  3. Division of Hematology, Department of Internal Medicine, Kinki University, School of Medicine, Sayama, Osaka, Japan

    F Urase & Y Maeda

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  1. S Nomura
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Correspondence to S Nomura.

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Nomura, S., Ishii, K., Shimizu, M. et al. Inflammatory pseudotumor following cord blood transplantation for adult T-cell leukemia. Bone Marrow Transplant 42, 493–494 (2008). https://doi.org/10.1038/bmt.2008.191

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