title: [Adult T-cell leukemia-lymphoma developed from an HTLV-1 carrier during treatment of B-cell lymphoma-associated hemophagocytic syndrome].
abstract: A 63-year-old woman was admitted to our hospital with high-grade fever, liver dysfunction, and pancytopenia. Computed tomography of the whole body revealed hepatosplenomegaly but no lymphoadenopaties. Bone marrow aspiration showed infiltrations of CD20-positive large atypical B-lymphocytes with severe hemophagocytosis. Although she was a human T-cell leukemia virus type 1 carrier, the atypical lymphocyte in bone marrow had IgH rearrangement but not TCR rearrangement. From these clinical and laboratory data, the patient was diagnosed as having B-cell lymphoma-associated hemophagocytic syndrome (B-LAHS) and treated with R-CHOP chemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone). After 4 cycles of R-CHOP, she had achieved complete remission. However, increased numbers of CD4+CD25+ flower cells were observed in peripheral blood and HTLV-1 provirus DNA was detected after 5 cycle of R-CHOP. The patient was diagnosed as adult T-cell leukemia-lymphoma (ATL) complicated by B-LAHS. Our observations suggest that continuous immunosuppressive statement for B-cell lymphoma or the chemotherapy against B-LAHS may induce the development of ATL in an HTLV-1 carrier.
authors: Department of Hematology, Akita University Graduate School of Medicine, Japan.
authors: Takayo
authors: T
authors: Nagao
authors: Naoto
authors: N
authors: Takahashi
authors: Hirobumi
authors: H
authors: Saitoh
authors: Shinsuke
authors: S
authors: Noguchi
authors: Yong-Mei
authors: YM
authors: Guo
authors: Mitsugu
authors: M
authors: Ito
authors: Atsushi
authors: A
authors: Watanabe
authors: Naohito
authors: N
authors: Fujishima
authors: Yoshihiro
authors: Y
authors: Kameoka
authors: Hiroyuki
authors: H
authors: Tagawa
authors: Makoto
authors: M
authors: Hirokawa
authors: Kenichi
authors: K
authors: Sawada
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived; D000971:Antineoplastic Combined Chemotherapy Protocols; D003520:Cyclophosphamide; D004317:Doxorubicin; D005260:Female; D015368:Human T-lymphotropic virus 1; D006801:Humans; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000628:therapy* / Q000821:virology; D051359:Lymphohistiocytosis, Hemophagocytic / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D016393:Lymphoma, B-Cell / Q000150:complications / Q000628:therapy*; D008875:Middle Aged; D011241:Prednisone; D000069283:Rituximab; D016896:Treatment Outcome; D014750:Vincristine
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; C571759:R-CHOP protocol; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone