Treatment of patients with adult T cell leukemia/lymphoma with cord blood transplantation: A japanese nationwide retrospective survey

Koji Kato, Ilseung Choi, Atsushi Wake, Naokuni Uike, Shuichi Taniguchi, Yukiyoshi Moriuchi, Yasushi Miyazaki, Hirohisa Nakamae, Eijirou Oku, Makoto Murata, Tetsuya Eto, Koichi Akashi, Hisashi Sakamaki, Koji Kato, Ritsuro Suzuki, Takeharu Yamanaka, Atae Utsunomiya

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20 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1968-1974
Number of pages7
JournalBiology of Blood and Marrow Transplantation
Volume20
Issue number12
DOIs
Publication statusPublished - Dec 1 2014

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

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