title: Adult T cell leukemia following HTLV-I-associated myelopathy/tropical spastic paraparesis: case reports and implication to the natural course of ATL.
abstract: Adult T cell leukemia (ATL) is the T cell malignancy caused by human T lymphotropic virus type I (HTLV-I), and HTLV-I is also the causative agent of HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Although HTLV-I causes both diseases, concomitant occurrence is reported to be rare. This paper describes two cases of HAM/TSP that developed into lymphoma-type ATL after the onset of HAM/TSP. In one case, the same HTLV-I infected clone could be detected by polymerase chain reaction in peripheral blood obtained when the patient was diagnosed as HAM/TSP. This finding showed that the HTLV-I clone already existed at the stage of HAM/TSP. Since frequent detection of clonal proliferation of HTLV-I infected cells has been reported previously in patients with HAM/TSP, careful follow-up is needed for patients with HAM/TSP.
authors.affiliation: Second Department of Internal Medicine, Kumamoto University School of Medicine, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Tamiya
authors.forename: M
authors.initials: M
authors.lastname: Matsuoka
authors.forename: S
authors.initials: S
authors.lastname: Takemoto
authors.forename: K
authors.initials: K
authors.lastname: Shimizu
authors.forename: K
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: S
authors.initials: S
authors.lastname: Mita
authors.forename: M
authors.initials: M
authors.lastname: Uchino
authors.forename: M
authors.initials: M
authors.lastname: Ando
authors.forename: T
authors.initials: T
authors.lastname: Miyaguni
authors.forename: K
authors.initials: K
authors.lastname: Kuniyoshi
mesh_terms: D001483:Base Sequence; D018450:Disease Progression; D005260:Female; D015368:Human T-lymphotropic virus 1 / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D015458:Leukemia, T-Cell / Q000473:pathology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D015493:Paraparesis, Tropical Spastic / Q000473:pathology / Q000821:virology*; D016133:Polymerase Chain Reaction