Risk Assessment in Adult T Cell Leukemia/Lymphoma Treated with Allogeneic Hematopoietic Stem Cell Transplantation

Makoto Yoshimitsu, Ryuji Tanosaki, Koji Kato, Takashi Ishida, Ilseung Choi, Yoshifusa Takatsuka, Takahiro Fukuda, Tetsuya Eto, Michihiro Hidaka, Naoyuki Uchida, Toshihiro Miyamoto, Yasuhiro Nakashima, Yukiyoshi Moriuchi, Koji Nagafuji, Yasuhiko Miyazaki, Tatsuo Ichinohe, Minoko Takanashi, Yoshiko Atsuta, Atae Utsunomiya

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Disease status at allogeneic hematopoietic cell transplantation (HCT) is an important pretransplant prognostic factor of HCT in adult T cell leukemia/lymphoma (ATL); however, other prognostic factors, including comorbidities, were not predictive in small cohort analyses. Several scoring systems (HCT-specific comorbidity index [HCT-CI]/modified European Group for Blood and Marrow Transplantation risk score [mEBMT]) have been adopted to predict HCT outcomes in other hematologic malignancies. We retrospectively evaluated HCT-CI and mEBMT to predict nonrelapse mortality (NRM) in 824 ATL patients registered in the Japan Society for Hematopoietic Cell Transplantation TRUMP database, from 2008 until 2013. A higher HCT-CI was associated with greater NRM when comparing HCT-CI 0 versus HCT-CI 1 to 3 and HCT-CI 0 versus HCT-CI ≥ 4. A higher mEBMT score was not associated with higher NRM when comparing mEBMT 0 to 3 with 4 to 6. Because ATL patients are older and consequently at risk of additional complications, we developed an optimized prognostic index for ATL (ATL-HCT-PI) using known risk factors: age, HCT-CI, and donor-recipient sex combination. The ATL-HCT-PI scores effectively predicted the 2-year NRM (22.0%, 27.7%, and 44.4%, respectively). Therefore, the newly developed ATL-HCT-PI, in combination with other risk factors, is more useful for predicting NRM in HCT for ATL patients.

Original languageEnglish
JournalBiology of Blood and Marrow Transplantation
DOIs
Publication statusAccepted/In press - 2017 Jan 1

Keywords

  • Adult T cell leukemia/lymphoma
  • Allogeneic hematopoietic cell transplantation
  • Comorbidities
  • Hematologic malignancies
  • Mortality

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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    Yoshimitsu, M., Tanosaki, R., Kato, K., Ishida, T., Choi, I., Takatsuka, Y., Fukuda, T., Eto, T., Hidaka, M., Uchida, N., Miyamoto, T., Nakashima, Y., Moriuchi, Y., Nagafuji, K., Miyazaki, Y., Ichinohe, T., Takanashi, M., Atsuta, Y., & Utsunomiya, A. (Accepted/In press). Risk Assessment in Adult T Cell Leukemia/Lymphoma Treated with Allogeneic Hematopoietic Stem Cell Transplantation. Biology of Blood and Marrow Transplantation. https://doi.org/10.1016/j.bbmt.2017.11.005