Τίτλος:
Antiretroviral activity of 5-azacytidine during treatment of a HTLV-1 positive myelodysplastic syndrome with autoimmune manifestations
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Myelodysplastic syndromes (MDS) are often accompanied by autoimmune phenomena. The underlying mechanisms for these associations remain uncertain, although T cell activation seems to be important. Human T-lymphotropic virus (HTLV-1) has been detected in patients with myelodysplastic syndromes, mostly in regions of the world which are endemic for the virus, and where association of HTLV-1 with rheumatological manifestation is not rare. We present here the case of a 58 year old man who presented with cytopenias, leukocytoclastic vasculitis of the skin and glomerulopathy, and was diagnosed as MDS (refractory anemia with excess blasts - RAEB 1). The patient also tested positive for HTLV-1 by PCR. After 8 monthly cycles of 5-azacytidine he achieved a complete hematologic remission. Following treatment, a second PCR for HTLV-1 was carried out and found to be negative. This is the first report in the literature of a HTLV-1-positive MDS with severe autoimmune manifestations, which was treated with the hypomethylating factor 5-azacitidine, achieving cytogenetic remission with concomitant resolution of the autoimmune manifestations, as well as HTLV-1-PCR negativity. HTLV-1-PCR negativity may be due to either immune mediated clearance of the virus, or a potential antiretroviral effect of 5-azacytidine. 5-azacytidine is known for its antiretroviral effects, although there is no proof of its activity against HTLV-1 infection in vivo. © 2011Diamantopoulos et al; licensee BioMed Central Ltd.
Συγγραφείς:
Diamantopoulos, P.T.
Michael, M.
Benopoulou, O.
Bazanis, E.
Tzeletas, G.
Meletis, J.
Vayopoulos, G.
Viniou, N.-A.
Περιοδικό:
Virology Journal
Λέξεις-κλειδιά:
azacitidine; busulfan; fludarabine; methotrexate; methylprednisolone; steroid; antineoplastic antimetabolite; antiretrovirus agent; azacitidine, adult; allogeneic hematopoietic stem cell transplantation; antiviral activity; article; autoimmune disease; bone marrow biopsy; case report; cytopenia; glomerulopathy; graft versus host reaction; human; Human T cell leukemia virus infection; leukocytoclastic vasculitis; male; multiple cycle treatment; myeloablative conditioning; myelodysplastic syndrome; pancytopenia; polymerase chain reaction; drug effect; genetics; Human T cell leukemia virus 1; isolation and purification; middle aged; myelodysplastic syndrome; treatment outcome, Human T-lymphotropic virus 1, Anti-Retroviral Agents; Antimetabolites, Antineoplastic; Autoimmune Diseases; Azacitidine; HTLV-I Infections; Human T-lymphotropic virus 1; Humans; Male; Middle Aged; Myelodysplastic Syndromes; Polymerase Chain Reaction; Treatment Outcome
DOI:
10.1186/1743-422X-9-1
