Allogeneic hematopoietic stem cell transplantation for adult T-cell leukemia-lymphoma with special emphasis on preconditioning regimen: a nationwide retrospective study
Open Access
- 23 August 2012
- journal article
- Published by American Society of Hematology in Blood
- Vol. 120 (8), 1734-1741
- https://doi.org/10.1182/blood-2012-03-414490
Abstract
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.Keywords
This publication has 36 references indexed in Scilit:
- Long-term outcomes after hematopoietic SCT for adult T-cell leukemia/lymphoma: results of prospective trialsBone Marrow Transplantation, 2010
- Competing Risks and Time‐Dependent CovariatesBiometrical Journal, 2010
- Regression modeling of competing risk using R: an in depth guide for cliniciansBone Marrow Transplantation, 2010
- Defining the Intensity of Conditioning Regimens: Working DefinitionsTransplantation and Cellular Therapy, 2009
- Reduced-Intensity Conditioning Regimen Workshop: Defining the Dose Spectrum. Report of a Workshop Convened by the Center for International Blood and Marrow Transplant ResearchTransplantation and Cellular Therapy, 2009
- Definition, Prognostic Factors, Treatment, and Response Criteria of Adult T-Cell Leukemia-Lymphoma: A Proposal From an International Consensus MeetingJournal of Clinical Oncology, 2009
- Allogeneic hematopoietic stem cell transplantation provides sustained long-term survival for patients with adult T-cell leukemia/lymphomaLeukemia, 2005
- Graft-versus-Tax Response in Adult T-Cell Leukemia Patients after Hematopoietic Stem Cell TransplantationCancer Research, 2004
- A Proportional Hazards Model for the Subdistribution of a Competing RiskJournal of the American Statistical Association, 1999
- A Proportional Hazards Model for the Subdistribution of a Competing RiskJournal of the American Statistical Association, 1999