Allogeneic hematopoietic stem cell transplantation for adult T-cell leukemia-lymphoma with special emphasis on preconditioning regimen: A nationwide retrospective study

Takashi Ishida, Masakatsu Hishizawa, Koji Kato, Ryuji Tanosaki, Takahiro Fukuda, Shuichi Taniguchi, Tetsuya Eto, Yoshifusa Takatsuka, Yasushi Miyazaki, Yukiyoshi Moriuchi, Michihiro Hidaka, Koichi Akashi, Naokuni Uike, Hisashi Sakamaki, Yasuo Morishima, Ritsuro Suzuki, Takeshi Nishiyama, Atae Utsunomiya

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106 Citations (Scopus)

Abstract

Adult T-cell leukemia-lymphoma (ATL) is an intractable mature T-cell neoplasm. We performed a nationwide retrospective study of allogeneic hematopoietic stem cell transplantation (HSCT) for ATL in Japan, with special emphasis on the effects of the preconditioning regimen. This is the largest study ofATL patients receiving HSCT. Median overall survival (OS) and 3-year OS of bone marrow or peripheral blood transplantation recipients (n = 586) was 9.9 months (95% confidence interval, 7.4-13.2 months) and 36% (32%-41%), respectively. These values for recipients of myeloablative conditioning (MAC; n = 280) and reduced intensity conditioning (RIC; n = 306) were 9.5 months (6.7-18.0 months) and 39% (33%-45%) and 10.0 months (7.2-14.0 months) and 34% (29%-40%), respectively. Multivariate analysis demonstrated 5 significant variables contributing to poorer OS, namely, older age, male sex, not in complete remission, poor performance status, and transplantation from unrelated donors. Although no significant difference in OS between MAC and RIC was observed, there was a trend indicating that RIC contributed to better OS in older patients. Regarding mortality, RIC was significantly associated with ATL-related mortality compared with MAC. In conclusion, allogeneic HSCT not only with MAC but also with RIC is an effective treatment resulting in long-term survival in selected patients with ATL.

Original languageEnglish
Pages (from-to)1734-1741
Number of pages8
JournalBlood
Volume120
Issue number8
DOIs
Publication statusPublished - 2012 Aug 23
Externally publishedYes

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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  • Cite this

    Ishida, T., Hishizawa, M., Kato, K., Tanosaki, R., Fukuda, T., Taniguchi, S., Eto, T., Takatsuka, Y., Miyazaki, Y., Moriuchi, Y., Hidaka, M., Akashi, K., Uike, N., Sakamaki, H., Morishima, Y., Suzuki, R., Nishiyama, T., & Utsunomiya, A. (2012). Allogeneic hematopoietic stem cell transplantation for adult T-cell leukemia-lymphoma with special emphasis on preconditioning regimen: A nationwide retrospective study. Blood, 120(8), 1734-1741. https://doi.org/10.1182/blood-2012-03-414490