Impact of Graft-versus-Host Disease on Allogeneic Hematopoietic Cell Transplantation for Adult T Cell Leukemia-Lymphoma Focusing on Preconditioning Regimens: Nationwide Retrospective Study

被引：39

作者：

Ishida, Takashi ^{[1
]}

Hishizawa, Masakatsu ^{[2
]}

Kato, Koji ^{[3
]}

Tanosaki, Ryuji ^{[4
]}

Fukuda, Takahiro ^{[5
]}

Takatsuka, Yoshifusa ^{[6
]}

Eto, Tetsuya ^{[7
]}

Miyazaki, Yasushi ^{[8
]}

Hidaka, Michihiro ^{[9
]}

Uike, Naokuni ^{[10
]}

Miyamoto, Toshihiro ^{[3
]}

Tsudo, Mitsuru ^{[11
]}

Sakamaki, Hisashi ^{[12
]}

Morishima, Yasuo ^{[13
]}

Suzuki, Ritsuro ^{[14
]}

Utsunomiya, Atae ^{[6
]}

机构：

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

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

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

[4] Natl Canc Ctr, Dept Blood Transfus & Cellular Therapy, Tokyo, Japan

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

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

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

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

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

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

[11] Osaka Red Cross Hosp, Dept Hematol, Osaka, Japan

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

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

[14] Nagoya Univ, Dept Hematopoiet Stem Cell Transplantat Data Mana, Nagoya, Aichi 4648601, Japan

来源：

BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION | 2013年 / 19卷 / 12期

关键词：

HTLV-1; ATL-related mortality; TRM; Mogamulizumab; MONOCLONAL-ANTIBODY KW-0761; ACUTE GVHD; COMPETING RISKS; LEUKEMIA/LYMPHOMA; SURVIVAL; TAX; IMMUNOTHERAPY; THERAPY; ASSOCIATION; INTENSITY;

D O I：

10.1016/j.bbmt.2013.09.014

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Allogeneic hematopoietic cell transplantation (HCT), but not autologous HCT, can provide long-term remission in some patients with adult T cell leukemia-lymphoma (ATL). We retrospectively analyzed the effects of acute graft-versus-host disease (GVHD) among the 616 patients with ATL who survived at least 30 days after allogeneic HCT with other than cord blood grafts. Multivariate analyses treating the occurrence of GVHD as a time-varying covariate demonstrated an association between grade I-II acute GVHD and favorable overall survival (OS) (hazard ratio [HR], 0.634; 95% confidence interval [Cl], 0.477 to 0.843), whereas grade III-IV acute GVHD showed a trend toward unfavorable OS (HR, 1.380; 95% Cl, 0.988 to 1.927) compared with nonacute GVHD. In subsequent multivariate analyses of patients who survived at least 100 days after HCT (n = 431), the presence of limited chronic GVHD showed a trend toward favorable OS (HR, 0.597; 95% Cl, 0.354 to 1.007), and extensive chronic GVHD had a significant effect on OS (HR, 0.585; 95% CI, 0.389 to 0.880). There were no significant interactions between myeloablative conditioning or reduced-intensity conditioning with OS even when acute GVHD was absent or present at grade I-II or grade or when chronic GVHD was absent, limited, or extensive. This study demonstrates the actual existence of graft-versus-ATL effects in patients with ATL regardless of whether myeloablative conditioning or reduced-intensity conditioning is used. (C) 2013 American Society for Blood and Marrow Transplantation.

引用

页码：1731 / 1739

页数：9

共 47 条

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