Clinical features and treatment outcomes of opportunistic infections among human T-lymphotrophic virus type 1 (HTLV-1) carriers and patients with adult T-cell leukemia-lymphoma (ATL) at a single institution from 2006 to 2016

Kawano, Noriaki; Nagahiro, Yuri; Yoshida, Shuro; Tahara, Yoshihiro; Himeji, Daisuke; Kuriyama, Takuro; Tochigi, Tatsuo; Nakaike, Takashi; Shimokawa, Tomonori; Yamashita, Kiyoshi; Ochiai, Hidenobu; Marutsuka, K; Mashiba, Koichi; Shimoda, Kazuya; Teshima, Takanori; Kikuchi, Ikuo

doi:10.3960/jslrt.18032

Cited by 24 publications

(16 citation statements)

References 24 publications

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“…In comparison to existing data, our cohort appears to have a higher rate of infective episodes [ 1 ] [ 1 , 2 ]. In addition, the burden of fungal disease was high in our cohort at 24%, with only 2.4% of infective episodes being associated with fungal prophylaxis.…”

Section: Discussioncontrasting

confidence: 57%

A Description of the Type, Frequency and Severity of Infections Among Sixteen Patients Treated for T-Cell Lymphoma

Ko¹,

Seah²,

Gilbertson³

et al. 2021

J Hematol

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Background Infections are an important cause of morbidity and mortality in T-cell lymphomas. Factors contributing to increased risk of infection include the nature of the underlying disease, as well as treatment-associated immunosuppression. Currently there are few reports describing the types of infections, including preventable infections, in this cohort of patients. The aim of the study was to identify the type, frequency and severity of infection in patients with T-cell lymphoma undergoing treatment. Methods A case series was performed on all patients with T-cell lymphoma over a 5-year period from 2011 to 2016 at a tertiary Australian hospital. Information was collected from medical record review regarding patient demographics, lymphoma treatment and outcomes, and infectious outcomes. Severe infections were recorded, defined as infection requiring hospitalization. Results Sixteen patients were identified with a diagnosis of T-cell lymphoma who received treatment at our institution. There were 42 discrete episodes of severe infections in total. Severe infections occurred in 81% of patients, with over 40% having more than one infection. The median length of hospital stay was 13 days, 33% required intensive care admission and 14% of infectious episodes resulted in death. Only 50% of infectious episodes were microbiologically proven, with the most common etiology being bacterial. The most commonly isolated organism overall was Staphylococcus aureus , with the most common source of infection being skin and soft tissue. There was one case of cytomegalovirus (CMV) infection and five cases (12%) of invasive fungal infection. The highest rates of infection occurred during progressive disease. Rates of prophylaxis were highest with antiviral agents, and comparatively lower with antibacterial and antifungal agents. Conclusion Infections are frequent, opportunistic and severe in patients with T-cell lymphoma. Our data suggests that fungal prophylaxis may be indicated with T-cell lymphoma.

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Section: Discussioncontrasting

confidence: 57%

A Description of the Type, Frequency and Severity of Infections Among Sixteen Patients Treated for T-Cell Lymphoma

Ko¹,

Seah²,

Gilbertson³

et al. 2021

J Hematol

View full text Add to dashboard Cite

show abstract

“…The frequency of opportunistic infections among HTLV-1 carriers and ATL patients is 1.5% and 6.5%, respectively. The pathogenic microorganisms are diverse, including Cryptococcus , Aspergillus , Pneumocystis , and Cytomegalovirus ( 17 ). Although the mechanisms underlying immunosuppression in ATL patients remain obscure, a reduced CD4-positive T-cell function due to HTLV-1 infection has been proposed to be a causative mechanism ( 18 , 19 ).…”

Section: Discussionmentioning

confidence: 99%

Adult T Cell Leukemia/Lymphoma Becoming Apparent during Treatment of Pulmonary Abscess and Empyema Caused by <i>Nocardia asiatica</i>: A Case Report and Review of the Literature

et al. 2022

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Nocardia is a Gram-positive bacterium that causes opportunistic infections. Nocardia asiatica was newly isolated in 2004, and there have been no case reports describing the empyema caused by N. asiatica. Adult T-cell leukemia/lymphoma (ATL) is a peripheral T-cell malignancy caused by human T-cell leukemia virus type 1 (HTLV-1). We herein report a case in which immunosuppression attributable to ATL may have led to pulmonary abscess and empyema caused by N. asiatica. Our case demonstrates the need to investigate causes of immunosuppression, including ATL, in patients showing nocardiosis.

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“…In this meta-analysis HTLV-1 infection was associated with a 1.57 adjusted Hazard Ratio for mortality unexplained by the risk of ATL. Carriers of HTLV-1 infection are also suspected to be at risk of other opportunistic infections (23) and cardiovascular disease (24) (Figure 1).…”

Section: Transmission and Diseasementioning

confidence: 99%

A Review of the Prevention of Mother-to-Child Transmission of Human T-Cell Lymphotrophic Virus Type 1 (HTLV-1) With a Proposed Management Algorithm

et al. 2022

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Human T cell lymphotropic virus type 1 (HTLV-1) is a human retrovirus that is endemic in a number of regions across the world. There are an estimated 5–10 million people infected worldwide. Japan is currently the only country with a national antenatal screening programme in place. HTLV-1 is primarily transmitted sexually in adulthood, however it can be transmitted from mother-to-child perinatally. This can occur transplacentally, during the birth process or via breastmilk. If HTLV-1 is transmitted perinatally then the lifetime risk of adult T cell leukemia/lymphoma rises from 5 to 20%, therefore prevention of mother-to-child transmission of HTLV-1 is a public health priority. There are reliable immunological and molecular tests available for HTLV-1 diagnosis during pregnancy and screening should be considered on a country by country basis. Further research on best management is needed particularly for pregnancies in women with high HTLV-1 viral load. A first step would be to establish an international registry of cases and to monitor outcomes for neonates and mothers. We have summarized key risk factors for mother-to-child transmission of HTLV-1 and subsequently propose a pragmatic guideline for management of mothers and infants in pregnancy and the perinatal period to reduce the risk of transmission. This is clinically relevant in order to reduce mother-to-child transmission of HTLV-1 and it's complications.

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Clinical features and treatment outcomes of opportunistic infections among human T-lymphotrophic virus type 1 (HTLV-1) carriers and patients with adult T-cell leukemia-lymphoma (ATL) at a single institution from 2006 to 2016

Cited by 24 publications

References 24 publications

A Description of the Type, Frequency and Severity of Infections Among Sixteen Patients Treated for T-Cell Lymphoma

A Description of the Type, Frequency and Severity of Infections Among Sixteen Patients Treated for T-Cell Lymphoma

Adult T Cell Leukemia/Lymphoma Becoming Apparent during Treatment of Pulmonary Abscess and Empyema Caused by <i>Nocardia asiatica</i>: A Case Report and Review of the Literature

A Review of the Prevention of Mother-to-Child Transmission of Human T-Cell Lymphotrophic Virus Type 1 (HTLV-1) With a Proposed Management Algorithm

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