Hematopoietic stem cell transplantation for familial hemophagocytic lymphohistiocytosis and Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis in Japan

Shouichi Ohga, Kazuko Kudo, Eiichi Ishii, Satoshi Honjo, Akira Morimoto, Yuko Osugi, Akihisa Sawada, Masami Inoue, Ken Tabuchi, Nobuhiro Suzuki, Yasushi Ishida, Shinsaku Imashuku, Shunichi Kato, Toshiro Hara

研究成果: ジャーナルへの寄稿記事

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Background. Post-transplant outcomes of hemophagocytic lymphohistiocytosis (HLH) patients were analyzed in Japan where Epstein-Barr virus (EBV)-associated severe forms are problematic. Methods. Fifty-seven patients (43 familial HLH [12 FHL2, 11 FHL3, 20 undefined], 14 EBV-HLH) who underwent stem cell transplantation (SCT) between 1995 and 2005 were enrolled based on the nationwide registration. Results. Fifty-seven patients underwent 61 SCTs, including 4 consecutive SCTs. SCTs were employed using allogeneic donors in 93% of cases (allo 53, twin 1, auto 3). Unrelated donor cord blood transplantation (UCBT) was employed in half of cases (21 FHL, 7 EBV-HLH). Reduced intensity conditioning was used in 26% of cases. The 10-year overall survival rates (median±SE%) were 65.0±7.9% in FHL and 85.7±9.4% in EBV-HLH patients, respectively. The survival of UCBT recipients was >65% in both FHL and EBV-HLH patients. Three out of four patients were alive with successful engraftment after second UCBT. FHL patients showed a poorer outcome due to early treatmentrelated deaths (<100 days, seven patients) and a higher incidence of sequelae than EBV-HLH patients (P=0.02). The risk of death for FHL patients having received an unrelated donor bone marrow transplant was marginally higher than that for a related donor SCT (P=0.05) and that for UCBT (P=0.07). Conclusions. EBV-HLH patients had a better prognosis after SCT than FHL patients. FHL patients showed either an equal or better outcome even after UCBT compared with the recent reports. UCB might therefore be acceptable as an alternate SCT source for HLH patients, although the optimal conditioning remains to be determined.

元の言語英語
ページ(範囲)299-306
ページ数8
ジャーナルPediatric Blood and Cancer
54
発行部数2
DOI
出版物ステータス出版済み - 2 1 2010

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All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

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