TY - JOUR
T1 - Transplantation of allogeneic hematopoietic stem cells for adult T-cell leukemia
T2 - A nationwide retrospective study
AU - Hishizawa, Masakatsu
AU - Kanda, Junya
AU - Utsunomiya, Atae
AU - Taniguchi, Shuichi
AU - Eto, Tetsuya
AU - Moriuchi, Yukiyoshi
AU - Tanosaki, Ryuji
AU - Kawano, Fumio
AU - Miyazaki, Yasushi
AU - Masuda, Masato
AU - Nagafuji, Koji
AU - Hara, Masamichi
AU - Takanashi, Minoko
AU - Kai, Shunro
AU - Atsuta, Yoshiko
AU - Suzuki, Ritsuro
AU - Kawase, Takakazu
AU - Matsuo, Keitaro
AU - Nagamura-Inoue, Tokiko
AU - Kato, Shunichi
AU - Sakamaki, Hisashi
AU - Morishima, Yasuo
AU - Okamura, Jun
AU - Ichinohe, Tatsuo
AU - Uchiyama, Takashi
PY - 2010/8/26
Y1 - 2010/8/26
N2 - Allogeneic hematopoietic stem cell transplantation (HSCT) is increasingly used as a curative option for adult T-cell leukemia (ATL), an intractable mature T-cell neoplasm causally linked with human T-cell leukemia virus type I (HTLV-I). We compared outcomes of 386 patients with ATL who underwent allogeneic HSCT using different graft sources: 154 received human leukocyte antigen (HLA)-matched related marrow or peripheral blood; 43 received HLA-mismatched related marrow or peripheral blood; 99 received unrelated marrow; 90 received single unit unrelated cord blood. After a median follow-up of 41 months (range, 1.5-102), 3-year overall survival for entire cohort was 33% (95% confidence interval, 28%-38%). Multivariable analysis revealed 4 recipient factors significantly associated with lower survival rates: older age (> 50 years), male sex, status other than complete remission, and use of unrelated cord blood compared with use of HLA-matched related grafts. Treatment-related mortality rate was higher among patients given cord blood transplants; disease-associated mortality was higher among male recipients or those given transplants not in remission. Among patients who received related transplants, donor HTLV-I seropositivity adversely affected disease-associated mortality. In conclusion, allogeneic HSCT using currently available graft source is an effective treatment in selected patients with ATL, although greater effort is warranted to reduce treatment-related mortality.
AB - Allogeneic hematopoietic stem cell transplantation (HSCT) is increasingly used as a curative option for adult T-cell leukemia (ATL), an intractable mature T-cell neoplasm causally linked with human T-cell leukemia virus type I (HTLV-I). We compared outcomes of 386 patients with ATL who underwent allogeneic HSCT using different graft sources: 154 received human leukocyte antigen (HLA)-matched related marrow or peripheral blood; 43 received HLA-mismatched related marrow or peripheral blood; 99 received unrelated marrow; 90 received single unit unrelated cord blood. After a median follow-up of 41 months (range, 1.5-102), 3-year overall survival for entire cohort was 33% (95% confidence interval, 28%-38%). Multivariable analysis revealed 4 recipient factors significantly associated with lower survival rates: older age (> 50 years), male sex, status other than complete remission, and use of unrelated cord blood compared with use of HLA-matched related grafts. Treatment-related mortality rate was higher among patients given cord blood transplants; disease-associated mortality was higher among male recipients or those given transplants not in remission. Among patients who received related transplants, donor HTLV-I seropositivity adversely affected disease-associated mortality. In conclusion, allogeneic HSCT using currently available graft source is an effective treatment in selected patients with ATL, although greater effort is warranted to reduce treatment-related mortality.
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U2 - 10.1182/blood-2009-10-247510
DO - 10.1182/blood-2009-10-247510
M3 - Article
C2 - 20479287
AN - SCOPUS:77956511566
SN - 0006-4971
VL - 116
SP - 1369
EP - 1376
JO - Blood
JF - Blood
IS - 8
ER -
