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

被引：125

作者：

Ishida, Takashi ^{[1
]}

Hishizawa, Masakatsu ^{[2
]}

Kato, Koji ^{[3
,15
]}

Tanosaki, Ryuji ^{[4
]}

Fukuda, Takahiro ^{[5
]}

Taniguchi, Shuichi ^{[6
]}

Eto, Tetsuya ^{[7
]}

Takatsuka, Yoshifusa ^{[8
]}

Miyazaki, Yasushi ^{[9
]}

Moriuchi, Yukiyoshi ^{[10
]}

Hidaka, Michihiro ^{[11
]}

Akashi, Koichi ^{[3
]}

Uike, Naokuni ^{[12
]}

Sakamaki, Hisashi ^{[13
]}

Morishima, Yasuo ^{[14
]}

Kato, Koji ^{[3
,15
]}

Suzuki, Ritsuro ^{[16
]}

Nishiyama, Takeshi ^{[17
]}

Utsunomiya, Atae ^{[8
]}

机构：

[1] Nagoya City Univ, Grad Sch Med Sci, Dept Med Oncol & Immunol, Mizuho Ku, Nagoya, Aichi 4678601, Japan

[2] Kyoto Univ, Dept Hematol & Oncol, Grad Sch Med, Kyoto, Japan

[3] Kyushu Univ, Dept Med & Biosyst Sci, Fukuoka 812, Japan

[4] Natl Canc Ctr, Div Clin Labs, Dept Pathol & Clin Labs, Tokyo, Japan

[5] Natl Canc Ctr, Stem Cell Transplantat Div, Tokyo, Japan

[6] Toranomon Gen Hosp, Dept Hematol, Tokyo, Japan

[7] Hamanomachi Hosp, Dept Hematol, Fukuoka, Japan

[8] Imamura Bun In Hosp, Dept Hematol, Kagoshima, Japan

[9] Nagasaki Univ, Dept Hematol, Grad Sch Biomed Sci, Nagasaki 852, Japan

[10] Sasebo City Gen Hosp, Dept Hematol, Sasebo, Japan

[11] Natl Hosp Org Kumamoto Med Ctr, Dept Hematol, Kumamoto, Japan

[12] Kyushu Natl Canc Ctr, Dept Hematol, Fukuoka, Japan

[13] Komagome Hosp, Tokyo Metropolitan Canc & Infect Dis Ctr, Tokyo, Japan

[14] Aichi Canc Ctr, Res Inst, Div Epidemiol & Prevent, Nagoya, Aichi 464, Japan

[15] Japanese Red Cross Nagoya First Hosp, Childrens Med Ctr, Div Hematol & Oncol, Nagoya, Aichi, Japan

[16] Nagoya Univ, Grad Sch Med, Dept Hematopoiet Stem Cell Transplantat Data Mana, Nagoya, Aichi 4648601, Japan

[17] Nagoya City Univ, Grad Sch Med Sci, Dept Publ Hlth, Nagoya, Aichi, Japan

来源：

BLOOD | 2012年 / 120卷 / 08期

关键词：

COMPETING RISK; LEUKEMIA/LYMPHOMA; ANTIBODY; THERAPY; IMMUNOTHERAPY; INTENSITY; CLINICIAN; SURVIVAL; SUBTYPES; OUTCOMES;

D O I：

10.1182/blood-2012-03-414490

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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 of ATL 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. (Blood. 2012;120(8):1734-1741)

引用

页码：1734 / 1741

页数：8

共 38 条

[1] Defining the Intensity of Conditioning Regimens: Working Definitions [J].