Table 5. Previous reports of HAM-mimicking myelitis after allo-HSCT and HAM after organ transplantation.
| Year | HAM | Recipient after OTP |
Development of HAM | Age, sex | Transplantation | Recipient HTLV-1 |
Donor HTLV-1 |
Recipient HTLV-1 after organ transplantation |
HTLV-1 DNA |
Neopterin | Immune suppression |
Donor cells | Therapy | Outcome | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Kawamata et al. | 2014 | HAM- mimicking myelitis |
- | 20 months | 63, F | BMT | + | - | - | - | 8 | CSP | CD4+ CXCR3+ CCR4+ |
mPSL | Imp |
| Present case | 2017 | Atypical HAM |
- | 5 months | 46, F | BMT | + | - | - | 10.8 copies/ 1000 cells) |
95 | FK+sMTx →CSP |
CD4+ CXCR3+ partially CCR4+ |
mPSL | Imp |
| Nagamine et al. | 2014 | HAM | + | 2 months | 38, F | RTP | - | + | + | 15/1000(PB) | 51 | FK/MMF | CD4+:54% | IFNα | Imp |
| Ramanan et al. | 2014 | HAM | + | 5 months | 56, M | RTP | - | + | + | n.d. | n.d. | FK/MMF PSL |
n.d. | PSL AZT |
Imp |
| Inose et al. | 2010 | HAM | + | 10 months | 51, M | RTP | - | n.e. | + | 7.4% | n.d. | CY/PSL | n.d. | IFNα | Imp |
| Kuroki et al. | 2007 | HAM | n.e. | 17 months | 40, M | RTP | n.e. | n.e. | n.e. | 0.83% | n.d. | CY/MMF/PSL | n.d. | PSL | Imp |
| Toro C et
al. Zarranz Imirizaidu JJ et al. |
2003 | HAM | + | 24 months | 54, F | RTP | - | + | + | 12.44% (164.4/1000) |
n.d. | CY | n.d. | PSL | PD |
| Toro C et
al. Zarranz Imirizaidu JJ et al. |
2003 | HAM | + | 20 months | 57, M | RTP | - | + | + | 16.44% (124.4/1000) |
n.d. | CY | n.d. | PSL | PD |
| Nakamura N et al. | 2001 | HAM | + | < 1 year | 48, M | RTP | n.e. | n.e. | + | n.d. | 121 | n.d. | n.d. | PE | Imp |
| Shintani et al. | 2001 | HAM | + | 7 years | 56, M | RTP | n.e. | n.e. | + | n.d. | n.d. | n.d. | n.d. | PSL | n.d. |
| Nakatsuji Y et al. | 2010 | HAM | + | 4 years | 50, M | RTP | - | n.e. | + | n.d. | n.d. | CY/MMF/PSL | n.d. | n.d. | n.d. |
| Kuroda Y et al. | 1992 | HAM | + | 11 months | 32, M | RTP | n.e. | + | + | n.d. | n.d. | CY/MZR PSL.AZA |
n.d. | PSL | Imp |
| Soyama A | 2008 | HAM | + | 20 months | 58, M | Liver TRP | + | + | + | 180/1000 | n.d. | TAC/PSL | n.d. | IFNα ribavium |
unchange |
| Toro C et
al. Zarranz Imirizaidu JJ et al. |
2003 | HAM | + | 18 months | 44, F | Liver TRP | - | + | + | + | n.d. | TAC | n.d. | PSL IFNα |
SD |
| Ozen S et al. | 2001 | HAM | + | 5 months | 41, M | Heart TRP | - | - | + | n.d. | n.d. | n.d. | n.d. | PSL | Imp |
In the present and previous reports of HAM-mimicking myelitis or atypical HAM after allo-HSCT and of HAM after organ transplantation (renal, liver, or heart transplantation), two cases were after allo-HSCT, and 13 cases were after organ transplantation, including 10 cases after renal transplantation, two cases after liver transplantation, and one case after heart transplantation. The majority of cases were donor-derived HAM. The presence of anti-HTLV-1 antibodies, and rapid development and progression of HAM were characteristic of HAM after organ transplantation. In one case after allo-HSCT, HAM-mimicking myelitis developed in the absence of anti–HTLV-1 antibodies and the presence of HTLV-1 proviral DNA, with rapid development and progression of the symptoms. In our case after allo-HSCT, atypical HAM developed in the absence of anti–HTLV-1 antibodies and presence of HTLV-1 proviral DNA, with rapid development and progression of the symptoms.