TY - JOUR
T1 - Treatment of patients with adult T cell leukemia/lymphoma with cord blood transplantation
T2 - A japanese nationwide retrospective survey
AU - Kato, Koji
AU - Choi, Ilseung
AU - Wake, Atsushi
AU - Uike, Naokuni
AU - Taniguchi, Shuichi
AU - Moriuchi, Yukiyoshi
AU - Miyazaki, Yasushi
AU - Nakamae, Hirohisa
AU - Oku, Eijirou
AU - Murata, Makoto
AU - Eto, Tetsuya
AU - Akashi, Koichi
AU - Sakamaki, Hisashi
AU - Kato, Koji
AU - Suzuki, Ritsuro
AU - Yamanaka, Takeharu
AU - Utsunomiya, Atae
N1 - Funding Information:
The authors thank the physicians and data managers at the institutes who contributed valuable data regarding ATLL-related transplantation to the Japan Society for Hematopoietic Cell Transplantation. We also thank all members of the data management committees of the JSHCT. This work was supported in part by MEXT KAKENHI Grant Number 25461453 (K.K.) and H22-Ganrinsho-Ippan-028 (N.U.).
Publisher Copyright:
© 2014 American Society for Blood and Marrow Transplantation.
PY - 2014/12/1
Y1 - 2014/12/1
N2 - Allogeneic bone marrow and peripheral blood stem cell transplantations are curative treatment modalities for adult Tcell leukemia/lymphoma (ATLL) because of the intrinsic graft-versus-ATLL effect. However, limited information is available regarding whether cord blood transplantation (CBT) induces a curative graft-versus-ATLL effect against aggressive ATLL. To evaluate the effect of CBT against ATLL, we retrospectively analyzed data from 175 patients with ATLL who initially underwent single-unit CBT. The 2-year overall survival (OS) rate was 20.6% (95% confidence interval [CI], 13.8% to 27.4%). A multivariate analysis revealed that the development of graft-versus-host disease (GVHD) was a favorable prognostic factor for OS (hazard ratio, .10; 95% CI, .01 to .94; P=.044). Furthermore, the 2-year OS (42.7%; 95% CI, 28.1% to 56.6%) of patients with grade 1 to 2 acute GVHD was higher than that of patients without acute GVHD (24.2%; 95% CI, 11.2% to 39.8%; P=.048). However, the cumulative incidence of treatment-related mortality (TRM) was high (46.1%; 95% CI, 38.2% to 53.7%), and early death was particularly problematic. In conclusion, CBT cures patients with ATLL partly through a graft-versus-ATLL effect. However, novel interventions will be required, particularly in the early phase, to reduce TRM and optimize GVHD.
AB - Allogeneic bone marrow and peripheral blood stem cell transplantations are curative treatment modalities for adult Tcell leukemia/lymphoma (ATLL) because of the intrinsic graft-versus-ATLL effect. However, limited information is available regarding whether cord blood transplantation (CBT) induces a curative graft-versus-ATLL effect against aggressive ATLL. To evaluate the effect of CBT against ATLL, we retrospectively analyzed data from 175 patients with ATLL who initially underwent single-unit CBT. The 2-year overall survival (OS) rate was 20.6% (95% confidence interval [CI], 13.8% to 27.4%). A multivariate analysis revealed that the development of graft-versus-host disease (GVHD) was a favorable prognostic factor for OS (hazard ratio, .10; 95% CI, .01 to .94; P=.044). Furthermore, the 2-year OS (42.7%; 95% CI, 28.1% to 56.6%) of patients with grade 1 to 2 acute GVHD was higher than that of patients without acute GVHD (24.2%; 95% CI, 11.2% to 39.8%; P=.048). However, the cumulative incidence of treatment-related mortality (TRM) was high (46.1%; 95% CI, 38.2% to 53.7%), and early death was particularly problematic. In conclusion, CBT cures patients with ATLL partly through a graft-versus-ATLL effect. However, novel interventions will be required, particularly in the early phase, to reduce TRM and optimize GVHD.
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U2 - 10.1016/j.bbmt.2014.08.012
DO - 10.1016/j.bbmt.2014.08.012
M3 - Article
C2 - 25172635
AN - SCOPUS:84912120970
VL - 20
SP - 1968
EP - 1974
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
SN - 1083-8791
IS - 12
ER -