Prognostic importance of pretransplant disease status for posttransplant outcomes in patients with adult T cell leukemia/lymphoma

Yoshitaka Inoue, Shigeo Fuji, Ryuji Tanosaki, Yoshihiro Inamoto, Takashi Tanaka, Ayumu Ito, Keiji Okinaka, Saiko Kurosawa, Sung Won Kim, Hitoshi Nakagama, Takahiro Fukuda

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Abstract

Adult T cell leukemia/lymphoma (ATL) is an aggressive T cell lymphoma with a poor prognosis. Although allogeneic hematopoietic stem cell transplantation (allo-HSCT) can be a curative treatment for ATL, a significant proportion of allo-HSCT recipients suffer from relapse/progression of ATL. Here we aimed to clarify the risk factors for and outcomes after posttransplant relapse/progression. We retrospectively reviewed 76 patients with ATL who received allo-HSCT at our institute. At the time of allo-HSCT, disease status was complete response in 17 patients, partial response in 29, stable disease (SD) in 18, and progressive disease (PD) in 12. In multivariate analysis, SD/PD at allo-HSCT, lymphoma subtype, reduced-intensity conditioning regimen, and time from diagnosis to allo-HSCT were associated with risk of relapse/progression. After allo-HSCT, 26 patients had relapse/progression at a median of 66 days (range, 13–2064 days). The 2-year overall survival rate after relapse/progression was only 19%. Compared with acute-type, lymphoma-type experienced local recurrence more frequently (1/15 acute vs. 7/11 lymphoma, P < 0.01) and had a significantly longer OS after relapse/progression (median; 112 days in acute vs. 554 days in lymphoma, P < 0.01). Since the prognosis of patients with ATL who experienced relapse/progression after allo-HSCT was poor, strategies to reduce the risk of these outcomes are warranted.

Original languageEnglish
Pages (from-to)1-11
Number of pages11
JournalBone Marrow Transplantation
DOIs
Publication statusAccepted/In press - 2018 Mar 9

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Adult T Cell Leukemia Lymphoma
Hematopoietic Stem Cell Transplantation
Recurrence
Lymphoma
T-Cell Lymphoma
Multivariate Analysis
Survival Rate

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Prognostic importance of pretransplant disease status for posttransplant outcomes in patients with adult T cell leukemia/lymphoma. / Inoue, Yoshitaka; Fuji, Shigeo; Tanosaki, Ryuji; Inamoto, Yoshihiro; Tanaka, Takashi; Ito, Ayumu; Okinaka, Keiji; Kurosawa, Saiko; Kim, Sung Won; Nakagama, Hitoshi; Fukuda, Takahiro.

In: Bone Marrow Transplantation, 09.03.2018, p. 1-11.

Research output: Contribution to journalArticle

Inoue, Yoshitaka ; Fuji, Shigeo ; Tanosaki, Ryuji ; Inamoto, Yoshihiro ; Tanaka, Takashi ; Ito, Ayumu ; Okinaka, Keiji ; Kurosawa, Saiko ; Kim, Sung Won ; Nakagama, Hitoshi ; Fukuda, Takahiro. / Prognostic importance of pretransplant disease status for posttransplant outcomes in patients with adult T cell leukemia/lymphoma. In: Bone Marrow Transplantation. 2018 ; pp. 1-11.
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abstract = "Adult T cell leukemia/lymphoma (ATL) is an aggressive T cell lymphoma with a poor prognosis. Although allogeneic hematopoietic stem cell transplantation (allo-HSCT) can be a curative treatment for ATL, a significant proportion of allo-HSCT recipients suffer from relapse/progression of ATL. Here we aimed to clarify the risk factors for and outcomes after posttransplant relapse/progression. We retrospectively reviewed 76 patients with ATL who received allo-HSCT at our institute. At the time of allo-HSCT, disease status was complete response in 17 patients, partial response in 29, stable disease (SD) in 18, and progressive disease (PD) in 12. In multivariate analysis, SD/PD at allo-HSCT, lymphoma subtype, reduced-intensity conditioning regimen, and time from diagnosis to allo-HSCT were associated with risk of relapse/progression. After allo-HSCT, 26 patients had relapse/progression at a median of 66 days (range, 13–2064 days). The 2-year overall survival rate after relapse/progression was only 19{\%}. Compared with acute-type, lymphoma-type experienced local recurrence more frequently (1/15 acute vs. 7/11 lymphoma, P < 0.01) and had a significantly longer OS after relapse/progression (median; 112 days in acute vs. 554 days in lymphoma, P < 0.01). Since the prognosis of patients with ATL who experienced relapse/progression after allo-HSCT was poor, strategies to reduce the risk of these outcomes are warranted.",
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