The development of adult T cell leukemia/lymphoma in renal transplant recipients: report of two cases with literature review

Abstract Backgrounds Therefore, reports on the risk of HTLV-1-related diseases in organ transplantation have increased recent years, and management HTLV renal remains a challenge. Patients methods We retrospectively analyzed four HTLV-1-positive recipients or donors among 89 cases from 2006 to 2021. Results Among recipients, two patients developed adult T cell leukemia/lymphoma (ATL) derived at approximately 3 years (1016 days 1195 days) after transplantation. Case 1 lymphoma-type ATL (an extranodal primary cutaneous variant), including skin pulmonary lesions. The patient achieved CR with FK tapering CHOP therapy following cord blood stem However, died 101 development because severe fungal infection. 2 acute-type an unusual phenotype CD4+8+30+. was treated palliative poor PS. Notably, case 1, histopathological findings showed high numbers PD-1-positive TIL cells ATL, suggesting exhausted correlation early onset ATL. Furthermore, 2, revealed CD 30 expression cells, importance development. Importantly, typical driver mutations, CCR4 truncation mutations C-terminal, TBL1XR1 mutation, TP53 mutation splice site. our present study previous strongly indicated that out one 59 “recipient” positive respectively. nationwide 4 10 “donor” HAM. These may be HTLV-I+ recipient HAM HTLV-1+ donor although precise mechanism unknown. Conclusions Thus, rapid progression outcomes should considered HTLV-1 endemic areas. immunological genetic mechanisms related believe important when considering immune environment itself.