Abstract

BACKGROUND
Renal transplantation (RTx) in carriers of human T-cell lymphotropic virus type 1 (HTLV-1) has a risk of developing overt leukemia upon immunosuppression. Although there have been a few reports of such cases, it is unclear HTLV-1 carrier if patients on the modern immunosuppressants would develop HTLV-1-associated myelopathy or adult T-cell leukemia lymphoma.
METHODS
We retrospectively reviewed the clinical outcomes of RTx in nine HTLV-1 carriers to assess a risk of developing leukemia from 2002 to 2011 using immunosuppression with a calcineurin inhibitor, mycophenolate mofetil (MMF), and steroid. The anti-CD25 monoclonal antibody basiliximab was used for induction. In two cases of ABO-incompatible RTx, the rituximab was also administered before RTx.
RESULTS
The ratio of male to female subjects was 2 to 7 with an overall mean recipient age of 54.3 ± 8.1 years. We prescribed cyclosporine (n = 5) or tacrolimus (n = 4). There was only one graft loss due to the death caused by aspiration pneumonia with a functioning graft. No one developed overt leukemia with combined treatment with MMF, basiliximab and rituximab.
CONCLUSION
We concluded that RTx in HTLV-1 carriers could be performed using a modern immunosuppressive regimen, without the risk of developing leukemia.

Links

Publisher Full Text

Authors

Shirai H, Suzuki M, Tomita Y, Iwadoh K, Kai K, Sannomiya A, Koyama I, Nakajima I, Fuchinoue S

Institution

Department of Surgery III, Tokyo Women's Medical University, Tokyo, Japan.

Source

Transplantation proceedings 44:1 2012 Jan pg 83-6

MeSH

Aged
Drug Therapy, Combination
Female
Graft Survival
HTLV-I Infections
Human T-lymphotropic virus 1
Humans
Immunosuppressive Agents
Japan
Kidney Transplantation
Leukemia-Lymphoma, Adult T-Cell
Male
Middle Aged
Paraparesis, Tropical Spastic
Retrospective Studies
Risk Assessment
Risk Factors
Survival Analysis
Time Factors
Treatment Outcome
Virus Activation

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22310586