[Alleviation of palmoplantar pustulosis associated with adult T cell leukemia/lymphoma after allogeneic hematopoietic stem cell transplantation].

Abstract

A 68-year-old female with palmoplantar pustulosis was referred to our hospital in July, 2009 because of liver dysfunction, a positive test for HTLV-1, and circulating abnormal lymphocytes with irregularly shaped nuclei. A diagnosis of acute type adult T cell leukemia/lymphoma (ATLL) was made based on generalized lymph node swelling and high levels of serum LDH, in addition to the findings described above. The associated palmoplantar pustulosis responded to some extent to antibiotics, steroid ointment, and narrow band UBV light irradiation. For ATLL, she was serially treated with CHOP chemotherapy, an LSG 15 protocol, and CytaBOM protocol with consequent partial remission. These chemotherapies did not affect the palmoplantar pustulosis. For ATLL in partial remission, we performed allogeneic peripheral blood stem cell transplantation (allo-PBSCT) from a related donor (HTLV-1-negative) with a conditioning regimen consisting of fludarabine, melphalan, and total body irradiation with 3 Gy in February, 2010. After the engraftment of donor hematopoietic cells, ATLL cells disappeared and the patient currently (as of April, 2012) remains in complete remission (CR). The residual palmoplantar pustulosis was further improved soon after allo-PBSCT and disappeared on Day 84 after transplantation. This refractory skin disease has also been in CR to date.

• Authors: Hiroshi Akasaka, Kisako Imaizumi, Emiko Sakane, Hiroko Tsunemine, Kiminari Ito, Taiichi Kodaka, Mayumi Matsumoto, Masao Matsuoka, Takayuki Takahashi
• Journal: [Rinsho ketsueki] The Japanese journal of clinical hematology (Rinsho Ketsueki) Vol. 53 Issue 8 Pg. 779-84 (Aug 2012) ISSN: 0485-1439 [Print] Japan
• PMID: 22975820 (Publication Type: Case Reports, English Abstract, Journal Article)

Topics

• Aged
• Female
• Hematopoietic Stem Cell Transplantation
• Humans
• Leukemia-Lymphoma, Adult T-Cell (complications, therapy)
• Psoriasis (etiology, therapy)
• Transplantation Conditioning
• Transplantation, Homologous
• Treatment Outcome