TY - JOUR
T1 - Improved survival of patients with aggressive ATL by increased use of allo-HCT
T2 - A prospective observational study
AU - Ito, Ayumu
AU - Nakano, Nobuaki
AU - Tanaka, Takashi
AU - Fuji, Shigeo
AU - Makiyama, Junya
AU - Inoue, Yoshitaka
AU - Choi, Ilseung
AU - Nakamae, Hirohisa
AU - Nagafuji, Koji
AU - Takase, Ken
AU - Machida, Shinichiro
AU - Takahashi, Tsutomu
AU - Sawayama, Yasushi
AU - Kamimura, Tomohiko
AU - Kato, Koji
AU - Kawakita, Toshiro
AU - Ogata, Masao
AU - Sakai, Rika
AU - Shiratori, Souichi
AU - Uchimaru, Kaoru
AU - Inamoto, Yoshihiro
AU - Utsunomiya, Atae
AU - Fukuda, Takahiro
N1 - Publisher Copyright:
© 2021 by The American Society of Hematology.
PY - 2021/10/26
Y1 - 2021/10/26
N2 - Aggressive adult T-cell leukemia/lymphoma (ATL) is a hematological malignancy that is difficult to treat with chemotherapy alone, and allogeneic hematopoietic cell transplantation (allo-HCT) is a potentially curative therapy. We conducted a multicenter, prospective, observational study to clarify the treatment outcomes of aggressive ATL in the current era. Between 2015 and 2018, 113 patients aged 70 years or younger with newly diagnosed aggressive ATL were enrolled. The median age at diagnosis was 61 years. Treatment outcomes were compared with those of 1792 ATL patients diagnosed between 2000 and 2013 in our previous retrospective study. The inclusion criteria were the same in both studies. The prospective cohort demonstrated better overall survival (OS) than the retrospective cohort (2-year OS, 45% vs 29%, respectively; P,.001), with a much higher proportion of patients receiving allo-HCT (80% vs 34%, respectively; P,.001) and a shorter interval from diagnosis to allo-HCT (median, 128 vs 170 days, respectively; P,.001). Among the 90 patients who received allo-HCT (cord blood, n 5 30; HLA-haploidentical related donors, n 5 20; other related donors, n 5 14; other unrelated donors, n 5 26), the 2-year probabilities of OS, nonrelapse mortality (NRM), and disease progression were 44%, 23%, and 46%, respectively. OS and NRM did not differ statistically according to donor type. Our results suggest that increased application of allo-HCT improved the survival of patients with aggressive ATL. The use of cord blood or HLA-haploidentical donors may be feasible for aggressive ATL when HLA-matched related donors are unavailable.
AB - Aggressive adult T-cell leukemia/lymphoma (ATL) is a hematological malignancy that is difficult to treat with chemotherapy alone, and allogeneic hematopoietic cell transplantation (allo-HCT) is a potentially curative therapy. We conducted a multicenter, prospective, observational study to clarify the treatment outcomes of aggressive ATL in the current era. Between 2015 and 2018, 113 patients aged 70 years or younger with newly diagnosed aggressive ATL were enrolled. The median age at diagnosis was 61 years. Treatment outcomes were compared with those of 1792 ATL patients diagnosed between 2000 and 2013 in our previous retrospective study. The inclusion criteria were the same in both studies. The prospective cohort demonstrated better overall survival (OS) than the retrospective cohort (2-year OS, 45% vs 29%, respectively; P,.001), with a much higher proportion of patients receiving allo-HCT (80% vs 34%, respectively; P,.001) and a shorter interval from diagnosis to allo-HCT (median, 128 vs 170 days, respectively; P,.001). Among the 90 patients who received allo-HCT (cord blood, n 5 30; HLA-haploidentical related donors, n 5 20; other related donors, n 5 14; other unrelated donors, n 5 26), the 2-year probabilities of OS, nonrelapse mortality (NRM), and disease progression were 44%, 23%, and 46%, respectively. OS and NRM did not differ statistically according to donor type. Our results suggest that increased application of allo-HCT improved the survival of patients with aggressive ATL. The use of cord blood or HLA-haploidentical donors may be feasible for aggressive ATL when HLA-matched related donors are unavailable.
UR - http://www.scopus.com/inward/record.url?scp=85118584185&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85118584185&partnerID=8YFLogxK
U2 - 10.1182/bloodadvances.2021004932
DO - 10.1182/bloodadvances.2021004932
M3 - Article
C2 - 34500464
AN - SCOPUS:85118584185
SN - 2473-9529
VL - 5
SP - 4156
EP - 4166
JO - Blood Advances
JF - Blood Advances
IS - 20
ER -