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Adult T-cell Leukemia Following Satralizumab Treatment for Neuromyelitis Optica Spectrum Disorder.

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Internal medicine (Tokyo, Japan) 📖 저널 OA 68.5% 2024: 6/6 OA 2025: 37/56 OA 2026: 57/84 OA 2024~2026 2026 Vol.65(5) p. 732-736
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Sakurai K, Ashikawa Y, Imaoka Y, Ohshima K, Sano F, Arai A, Yagishita N, Araya N, Nakashima M, Horibe E, Sato T, Yamano Y

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A 78-year-old woman with aquaporin 4 antibody-positive neuromyelitis optica spectrum disorder (NMOSD) developed acute-type adult T-cell leukemia (ATL) 1 month after initiating satralizumab, without pr

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APA Sakurai K, Ashikawa Y, et al. (2026). Adult T-cell Leukemia Following Satralizumab Treatment for Neuromyelitis Optica Spectrum Disorder.. Internal medicine (Tokyo, Japan), 65(5), 732-736. https://doi.org/10.2169/internalmedicine.5938-25
MLA Sakurai K, et al.. "Adult T-cell Leukemia Following Satralizumab Treatment for Neuromyelitis Optica Spectrum Disorder.." Internal medicine (Tokyo, Japan), vol. 65, no. 5, 2026, pp. 732-736.
PMID 40738679 ↗

Abstract

A 78-year-old woman with aquaporin 4 antibody-positive neuromyelitis optica spectrum disorder (NMOSD) developed acute-type adult T-cell leukemia (ATL) 1 month after initiating satralizumab, without prior human T-cell leukemia virus type 1 screening. She presented with respiratory symptoms and hematochezia after receiving three doses. Laboratory tests revealed abnormal lymphocytosis and HTLV-1 positivity, with monoclonal proliferation. Despite CHOP chemotherapy, the patient died within two weeks of treatment initiation. interleukin-6 inhibition may impair the host defense against HTLV-1 oncogenesis. This case highlights the potential risk of ATL following treatment with satralizumab, especially in HTLV-1 endemic areas, and the importance of HTLV-1 screening and clonality assessment before treatment in patients with NMOSD.

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