Panuveitis induced by donor-derived CD8+ T cells after allogeneic hematopoietic stem cell transplantation for adult T-cell leukemia

Atsunobu Takeda; Teppei Sakoda; Nobuyo Yawata; Koji Kato; Eiichi Hasegawa; Takahiro Shima; Shinichi Hikita; Keiko Yoshitomi; Katsuto Takenaka; Yoshinao Oda; Koichi Akashi; Koh-Hei Sonoda

doi:10.1016/j.ajoc.2022.101673

Panuveitis induced by donor-derived CD8⁺ T cells after allogeneic hematopoietic stem cell transplantation for adult T-cell leukemia

Am J Ophthalmol Case Rep. 2022 Aug 5:27:101673. doi: 10.1016/j.ajoc.2022.101673. eCollection 2022 Sep.

Authors

Affiliations

¹ Department of Ophthalmology, Japan.
² Department of Medicine and Biosystemic Science, Japan.
³ Department of Ocular Pathology and Imaging Science, Japan.
⁴ Department of Hematology, Clinical Immunology, and Infectious Diseases, Graduate School of Medicine, Ehime University, Japan.
⁵ Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Abstract

Purpose: This article presents a case of panuveitis that occurred after unrelated allogeneic hematopoietic stem cell transplantation (allo-HSCT) in a patient with lymphoma-type human T-cell leukemia virus type-1 (HTLV-1)-associated adult T-cell leukemia (ATL).

Observations: A 45-year-old man developed unilateral panuveitis 18 months after undergoing allo-HSCT. He underwent vitrectomy, and depositions of grey-white granules localized on the retinal artery were observed in the eye. Cytological examination of the vitreous aspirates showed that the atypical lymphoid cells stained positive for CD3 and CD8, but negative for CD4, B-cell markers, and cytomegalovirus antigen. Interphase fluorescence in situ hybridization using X- and Y-chromosome probes revealed complete donor chimerism in CD8⁺ T cells in the vitreous aspirates.

Conclusions and importance: Donor-derived CD8⁺ T lymphocytes can induce panuveitis like HTLV-1-assiciated uveitis after allo-HSCT in patients with ATL. Pathological diagnosis of vitreous infiltration by vitrectomy is helpful in patients with ATL. Donor-derived CD8⁺ T lymphocytes-induced panuveitis is recurrent but susceptible to regional corticosteroid treatment.

Keywords: Adult T cell leukemia; Allogeneic hematopoietic stem cell transplantation; Donor-derived CD8+ T lymphocytes; HTLV-1-Associated uveitis; Human T-cell lymphotropic virus type-1.

Publication types

Case Reports