Abstract
Adult T cell lymphoma-leukemia (ATL) is a highly aggressive disease and allogeneic hematopoietic transplantation (allo-HSCT) is the only therapeutic option for achieving a cure. However, some ATL patients cannot undergo HSCT. One of the important reasons for restricting HSCT in ATL is the high incidence of pulmonary complications associated with ATL including opportunistic infections, infiltration of ATL cells, and HTLV-1 associated bronchopneumonopathy. Herein, we report an ATL case with pulmonary infiltration of ATL cells successfully treated with allo-HSCT after improvement of pulmonary function with administration of the anti-CCR4 antibody mogamulizumab. To our knowledge, this is the first ATL case showing improvement of pulmonary invasion of ATL cells after treatment with mogamulizumab. In addition, this case suggests that mogamulizumab treatment might be useful as a bridge to allo-HSCT in ATL patients.

PMID: 25765802 [Pubmed - In-Data-Review]

Abstract
Adult T-cell leukemia/lymphoma (ATLL) is a mature T-cell neoplasm with extremely poor prognosis caused by human T-cell leukemia virus type 1 (HTLV-1). The distribution of HTLV-1 and the incidence of ATLL in endemic areas have been well described, however, little is known about the incidences and the trends of the disease in nonendemic areas. Recently, studies have shown that the HTLV-1 carriers are increasing in nonendemic areas. Also, the incidence of ATLL seems to be significantly increasing in nonendemic areas suggesting that HTLV-1 carriers have emigrated from endemic areas. These epidemiologic studies indicate the necessity of edification of the disease caused by HTLV-1 and establishing appropriate preventive methods against infection in nonendemic areas.

PMID: 25762122 [ - ]

成人T细胞白血病/淋巴瘤主要是由高度多形性的淋巴样细胞组成的外周T细胞肿瘤。通常广泛播散，是由人类逆转录病毒，即人类T细胞白血病病毒引起。发生的皮损分为红斑、丘疹和结节。发生在头颅为广泛的溶骨性破坏。最常见类型是以白血病为特征的急性型，常伴有明显的白细胞数目增多、皮疹和全身淋巴结肿大。ATLL表现为广泛的细胞形态谱系：多形性小细胞型、多形性中和大细胞型、间变型和罕见的血管免疫母细胞型。一些病例表现为白细胞侵袭模式。尽管有时可见嗜酸性粒细胞，但背景中炎细胞稀少，本例说是如此。肿瘤性淋巴细胞典型呈中至大细胞，常有明显的多形性。核染色质呈粗块状，核仁清楚，有时很显著。可见不同比例的具有转化核和疏松染色质的母细胞样细。也可见巨细胞，核呈脑回状或分叶状。罕见病例主要由核形不规则的小淋巴细胞组成。