Adult T-Cell Leukemia-Lymphoma during Pregnancy

Amor, Martin Miguel Inocencio; Olaso, Aedan Simon; Atienza, R Y; Stueben, Benjamin; Kossev, Plamen

doi:10.1155/2013/631825

Cited by 5 publications

(8 citation statements)

References 6 publications

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“…There have been only four previously reported cases of ATL during pregnancy (Table ) . All cases were diagnosed as acute ATL during the second to third trimesters.…”

Section: Discussionmentioning

confidence: 99%

“…3 There have been only four previously reported cases of ATL during pregnancy (Table 1). [7][8][9][10] All cases were diagnosed as acute ATL during the second to third trimesters. The clinical course in all patients was aggressive despite medical treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, to prevent mother‐to‐child transmission of HTLV‐1, since 2011, it is recommended that all pregnant women in Japan are screened for the HTLV‐1 antibody . There have been only four previously reported cases of ATL during pregnancy . None of those women, however, had undergone HTLV‐1 screening.…”

Section: Introductionmentioning

confidence: 99%

“…6 There have been only four previously reported cases of ATL during pregnancy. [7][8][9][10] None of those women, however, had undergone HTLV-1 screening. They developed acute ATL in the second or third trimesters, and three of them died after delivery.…”

Section: Introductionmentioning

confidence: 99%

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Adult T‐cell leukemia–lymphoma in a pregnant woman diagnosed as a human T‐cell lymphotropic virus type 1 carrier

Fuchi

Miura

Imaizumi

et al. 2015

J of Obstet and Gynaecol

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Human T-cell leukemia virus type 1 (HTLV-1) is the causative agent of adult T-cell leukemia-lymphoma (ATL), which is difficult to cure. In Japan, a nationwide HTLV-1 screening test in pregnant women has been recommended since 2011. A 30-year-old woman was diagnosed as being an HTLV-1 carrier in her previous pregnancy. During the current pregnancy, she had persistent fever and cough. Although she had treatment with antibiotics, peripheral white blood cell count remained high, with an abnormal lymphocyte count. Given that she was an HTLV-1 carrier, she was diagnosed with unfavorable chronic ATL (aggressive ATL) at 12 weeks gestation. After pregnancy termination, her ATL status became favorable chronic ATL (indolent ATL). Therefore, watchful waiting was performed until disease progression. This is the first case report of chronic ATL in early pregnancy, in a woman already diagnosed as an HTLV-1 carrier on screening test.

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“…There have been only four previously reported cases of ATL during pregnancy (Table ) . All cases were diagnosed as acute ATL during the second to third trimesters.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Adult T‐cell leukemia–lymphoma in a pregnant woman diagnosed as a human T‐cell lymphotropic virus type 1 carrier

Fuchi

Miura

Imaizumi

et al. 2015

J of Obstet and Gynaecol

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“…ATL in pregnancy has been reported. The majority were acute ATL and most patients died soon after delivery (by pre labor cesarean section [PLCS]), despite treatment (Utsumi et al, 1996; Safdar et al, 2002; Amor et al, 2013). Interestingly, there is one report of chronic ATL in a pregnant woman, previous diagnosed as asymptomatic carrier (AC).…”

Section: Htlv-1 Infection In Pregnant Womenmentioning

confidence: 99%

Mother-to-Child HTLV-1 Transmission: Unmet Research Needs

Rosadas

Taylor

2019

Front. Microbiol.

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Mother-to-child transmission (MTCT) of Human T-cell lymphotropic virus type 1 (HTLV-1) causes lifelong infection. At least 5–10 million individuals worldwide are currently living with HTLV-1. Studies of regional variation are required to better understand the contribution of MTCT to the global burden of infection. Although most infected individuals remain asymptomatic ∼10% develop high morbidity, high mortality disease. Infection early in life is associated with a higher risk of disease development. Adult T-cell leukemia (ATL), which is caused by HTLV-1 and has a median survival of 8 months is linked to MTCT, indeed evidence of ATL following infection as an adult is sparse. Infective dermatitis also only occurs following neonatal infection. Whilst HTLV-1-associated myelopathy (HAM) follows sexual and iatrogenic infection approximately 30% of patients presenting with HAM/TSP acquired the infection through their mothers. HAM/TSP is a disabling neurodegenerative disease that greatly impact patient’s quality of life. To date there is no cure for HTLV-1 infection other than bone marrow transplantation for ATL nor any measure to prevent HTLV-1 associated diseases in an infected individual. In this context, prevention of MTCT is expected to contribute disproportionately to reducing both the incidence of HTLV-1 and the burden of HTLV-1 associated diseases. In order to successfully avoid HTLV-1 MTCT, it is important to understand all the variables involved in this route of infection. Questions remain regarding frequency and risk factors for in utero peri-partum transmission whilst little is known about the efficacy of pre-labor cesarean section to reduce these infections. Understanding the contribution of peripartum infection to the burden of disease will be important to gauge the risk-benefit of interventions in this area. Few studies have examined the impact of HTLV-1 infection on fertility or pregnancy outcomes nor the susceptibility of the mother to infection during pregnancy and lactation. Whilst breast-feeding is strongly associated with transmission and avoidance of breast-feeding a proven intervention little is known about the mechanism of transmission from the breast milk to the infant and there have been no clinical trials of antiretroviral therapy (ARV) to prevent this route of transmission.

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

Aval

Boullier

Lyall

et al. 2020

eJHaem

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Introduction Chronic infection with human T‐cell lymphotropic virus type‐1 (HTLV‐1) may result in aggressive adult T‐cell leukaemia/lymphoma (ATL) in 4‐6% carriers. The majority of this risk arises in carriers infected during infancy, and so each infant has ∼25% lifetime risk. Other risk factors include a family history of ATL. Antenatal HTLV‐1 screening is not undertaken in the UK. Methods Here we describe four cases of ATL diagnosed during pregnancy and describe strategies to minimise HTLV‐1 transmission to neonates. Results/conclusion These cases highlight undiagnosed HTLV‐1 in pregnancy which allows ongoing mother to child vertical transmission and risk of future ATL. We recommend the UK National Screening Committee incorporate HTLV‐1 serology into antenatal screening.

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Adult T-Cell Leukemia-Lymphoma during Pregnancy

Cited by 5 publications

References 6 publications

Adult T‐cell leukemia–lymphoma in a pregnant woman diagnosed as a human T‐cell lymphotropic virus type 1 carrier

Adult T‐cell leukemia–lymphoma in a pregnant woman diagnosed as a human T‐cell lymphotropic virus type 1 carrier

Mother-to-Child HTLV-1 Transmission: Unmet Research Needs

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

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