Adult T cell leukaemia/lymphoma (ATL) in pregnancy: A UK case series

Aval, Leila Motedayеn; Boullier, Mary; Lyall, Hermione; Collins, Graham P.; Ayto, Robert; Kelly, Dominic F.; Tedder, Richard S.; Drysdale, Simon B.; Taylor, Graham P.; Cook, Lucy

doi:10.1002/jha2.142

Cited by 7 publications

(5 citation statements)

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“…Therefore, they require regular medical check-ups and monitoring of the HTLV-1 PVL for the early detection of HTLV-1-associated diseases, not only by obstetric gynecologists, but also by hematologists. This is primarily because it has been well-established that the higher the PVL in HTLV-1-infected asymptomatic carriers, the higher their risk of developing HTLV-1-associated diseases ( Nagai et al, 1998 ; Iwanaga et al, 2010 ), but also because a number of case reports have indicated the development of ATL in HTLV-1-positive pregnant mothers with a high PVL ( Ohba et al, 1988 ; Utsumi et al, 1996 ; Safdar et al, 2002 ; Amor et al, 2013 ; Motedayen Aval et al, 2020 ; Ramassamy et al, 2020 ). In APP Nagasaki, one asymptomatic HTLV-1-positive pregnant woman developed ATL ( Fuchi et al, 2016 ).…”

Section: Discussionmentioning

confidence: 99%

Frequency of HTLV-1 seroconversion between pregnancies in Nagasaki, Japan, 2011–2018

et al. 2022

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BackgroundHuman T-cell leukemia virus type-1 (HTLV-1) is transmitted vertically from an infected mother to her child via breastfeeding during infancy or horizontally via sexual contact. However, little information is available on the HTLV-1 seroconversion rate in pregnant mothers and the impact of new HTLV-1 infection on mothers and babies during the perinatal period.MethodsFrom the database of a prefecture-wide antenatal adult T-cell leukemia prevention program in Nagasaki, Japan, we extracted data on 57,323 pregnant women who were screened for anti-HTLV-1 antibody during 2011–2018. Data on the 16,863 subjects whose HTLV-1 proviral load (PVL) was measured more than twice were included in our analyses.ResultsIn total, 133 (0.79%) pregnant women were HTLV-1-positive during their first pregnancy and nine (0.05%) seroconverted before or during subsequent pregnancies (between pregnancies). The median PVL (per 100 peripheral blood mononuclear cells) was significantly lower in the seroconverted mothers (0.10%) than in the initially seropositive mothers (0.15%). A repeated measures correlation analysis for the individual PVLs of the HTLV-1-positive pregnant women showed that PVL increased with parity number (rrm = 0.25) with no perinatal problems.ConclusionThe HTLV-1 seroconversion rate between pregnancies was 0.05%, and their HTLV-1 PVL increased annually but no perinatal problems were noted.

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Section: Discussionmentioning

confidence: 99%

Frequency of HTLV-1 seroconversion between pregnancies in Nagasaki, Japan, 2011–2018

et al. 2022

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“…HTLV-1/2 testing should be offered for relatives, including sexual partners and children of previous pregnancies. Antiretroviral drugs do not decrease HTLV-1/2 PVL in established infection and are not currently recommended for the prevention of mother-to-child transmission, although this has been offered in very high–risk cases of mothers with ATL in pregnancy [ 69 ]. Although some argue that cesarean section should be recommended to pregnant women with HTLV-1/2 infection [ 70 ], there is no consensus about the impact of the procedure in reducing the risk of HTLV-1/2 mother-to-child transmission.…”

Section: Methodsmentioning

confidence: 99%

Blocking HTLV-1/2 silent transmission in Brazil: Current public health policies and proposal for additional strategies

et al. 2021

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Human T-cell lymphotropic viruses 1 and 2 (HTLV-1/2) are relatively common in Brazil but remain silent and neglected infections. HTLV-1 is associated with a range of diseases with high morbidity and mortality. There is no curative treatment for this lifelong infection, so measures to prevent transmission are essential. This narrative review discusses HTLV-1/2 transmission routes and measures to prevent its continuous dissemination. The public health policies that are currently implemented in Brazil to avoid HTLV-1/2 transmission are addressed, and further strategies are proposed.

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“…In a case series published in the United Kingdom in 2021, zidovudine was administered to four mothers who developed ATL during pregnancy and to their babies. The authors reported that MTCT was observed in one of the four mothers, but the outcomes of the other three were unknown because of the short follow-up period [ 120 ]. Since there have been no studies on asymptomatic carriers who have not developed ATL, further investigation is warranted.…”

Section: Strategies To Prevent Htlv-1 Mtctmentioning

confidence: 99%

How Can We Prevent Mother-to-Child Transmission of HTLV-1?

Itabashi¹,

Miyazawa

Uchimaru

2023

IJMS

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The perception of human T-cell leukemia virus type 1 (HTlV-1) infection as a “silent disease” has recently given way to concern that its presence may be having a variety of effects. HTLV-1 is known to cause adult T-cell leukemia (ATL), an aggressive cancer of peripheral CD4 T cells; however, it is also responsible for HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Most patients develop ATL as a result of HTLV-1 mother-to-child transmission. The primary route of mother-to-child transmission is through the mother’s milk. In the absence of effective drug therapy, total artificial nutrition such as exclusive formula feeding is a reliable means of preventing mother-to-child transmission after birth, except for a small percentage of prenatal infections. A recent study found that the rate of mother-to-child transmission with short-term breastfeeding (within 90 days) did not exceed that of total artificial nutrition. Because these preventive measures are in exchange for the benefits of breastfeeding, clinical applications of antiretroviral drugs and immunotherapy with vaccines and neutralizing antibodies are urgently needed.

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Adult T cell leukaemia/lymphoma (ATL) in pregnancy: A UK case series

Cited by 7 publications

References 20 publications

Frequency of HTLV-1 seroconversion between pregnancies in Nagasaki, Japan, 2011–2018

Frequency of HTLV-1 seroconversion between pregnancies in Nagasaki, Japan, 2011–2018

Blocking HTLV-1/2 silent transmission in Brazil: Current public health policies and proposal for additional strategies

How Can We Prevent Mother-to-Child Transmission of HTLV-1?

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