Adult T-Cell Leukemia in a Liver Transplant Recipient That Did Not Progress after Onset of Graft Rejection

  • Shinsuke Suzuki
  • Kimiharu Uozumi
  • Masahiko Maeda
  • Yoshiko Yamasuji
  • Shin-ichi Hashimoto
  • Yasuji Komorizono
  • Satsuki Owatari
  • Masahito Tokunaga
  • Kouichi Haraguchi
  • Naomichi Arima
Case Report

DOI: 10.1532/IJH97.05158

Cite this article as:
Suzuki, S., Uozumi, K., Maeda, M. et al. Int J Hematol (2006) 83: 429. doi:10.1532/IJH97.05158

Abstract

A liver allograft recipient developed acute-type adult T-cell leukemia (ATL) during tacrolimus treatment, 2 years after undergoing transplantation for subacute fulminant hepatitis. Both donor and recipient were asymptomatic carriers of human T- cell lymphotropic virus type I (HTLV-I), but the ATL cells originated from the recipient. Tacrolimus treatment was discontinued, and combination chemotherapy was administered. The patient achieved complete remission, but the transplanted liver was acutely and chronically rejected. The patient did not respond to rescue therapy with tacrolimus, prednisolone, and mycophenolate mofetil and died of hepatic failure. Liver biopsies showed CD4+ ATL cell infiltration at the onset of ATL but not at the terminal stage. Moreover, Southern blotting revealed clonal integration of HTLV-I into the host genome of lymphoma cells at onset but not at the terminal stage. ATL after liver transplantation has not been previously described. The clinical course of the posttransplantational ATL was atypical, because it did not progress after the onset of rejection.

Key words

ATLLiver transplantationRejection

Copyright information

© The Japanese Society of Hematology 2006

Authors and Affiliations

  • Shinsuke Suzuki
    • 1
  • Kimiharu Uozumi
    • 3
  • Masahiko Maeda
    • 2
  • Yoshiko Yamasuji
    • 2
  • Shin-ichi Hashimoto
    • 2
  • Yasuji Komorizono
    • 4
  • Satsuki Owatari
    • 1
  • Masahito Tokunaga
    • 1
  • Kouichi Haraguchi
    • 1
  • Naomichi Arima
    • 3
  1. 1.Department of Haematology and ImmunologyKagoshima University HospitalKagoshimaJapan
  2. 2.Departments of GastroenterologyKagoshima University HospitalKagoshimaJapan
  3. 3.Departments of Division of Host ResponseCenter for Chronic Viral Diseases, Faculty of Medicine, Kagoshima UniversityKagoshimaJapan
  4. 4.Departments of Nanpu HospitalKagoshimaJapan