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Allogeneic hematopoietic stem cell transplantation provides sustained long-term survival for patients with adult T-cell leukemia/lymphoma.

Abstract
Adult T-cell leukemia/lymphoma (ATLL) is a distinct peripheral T-cell neoplasm that is highly resistant to chemotherapy. Several groups, including ours, have reported encouraging results of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for patients with ATLL. To confirm our previous report and to establish the basis for a phase II clinical study, we analyzed 40 allo-HSCT for acute and lymphoma types of ATLL in seven institutions in Japan between 1997 and 2002. All evaluable cases entered complete remission (CR) after allo-HSCT and the median survival time was 9.6 months for all patients. The estimated 3-year overall and relapse-free survival, and disease relapse were 45.3, 33.8 and 39.3%, respectively. Among 10 cases with ATLL relapse, five cases achieved CR again: three by the reduction or cessation of immunosuppressive agents, which suggested a graft-versus-ATLL (GvATLL) effect. However, univariate or multivariate analysis did not show any benefit of graft-versus-host disease (GVHD) on the prevention of relapse. These results suggested that allo-HSCT was effective for some patients with aggressive ATLL, and that the GvATLL effect could be achieved even without GVHD. A new phase II trial to test the efficacy of allo-HSCT for ATLL is warranted.
AuthorsT Fukushima, Y Miyazaki, S Honda, F Kawano, Y Moriuchi, M Masuda, R Tanosaki, A Utsunomiya, N Uike, S Yoshida, J Okamura, M Tomonaga
JournalLeukemia (Leukemia) Vol. 19 Issue 5 Pg. 829-34 (May 2005) ISSN: 0887-6924 [Print] England
PMID15744352 (Publication Type: Journal Article, Multicenter Study)
Topics
  • Adult
  • Analysis of Variance
  • Female
  • Graft vs Host Disease (etiology, therapy)
  • Hematopoietic Stem Cell Transplantation (adverse effects)
  • Humans
  • Japan (epidemiology)
  • Leukemia-Lymphoma, Adult T-Cell (mortality, therapy)
  • Male
  • Middle Aged
  • Reproducibility of Results
  • Retrospective Studies
  • Survival Analysis
  • Time Factors
  • Transplantation, Homologous

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