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Infections

Characteristic patterns of relapse after allogeneic hematopoietic SCT for adult T-cell leukemia–lymphoma: a comparative study of recurrent lesions after transplantation and chemotherapy by the Nagasaki Transplant Group

Bone Marrow Transplantation volume 50, pages 585–591 (2015)Cite this article

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Abstract

Allogeneic hematopoietic SCT (allo-SCT) is a promising therapy that may provide long-term durable remission for adult T-cell leukemia–lymphoma (ATL) patients; however, the incidence of relapse associated with ATL remains high. To determine the clinical features of these patients at relapse, we retrospectively analyzed tumor lesions in 30 or 49 patients who relapsed following allo-SCT or chemotherapy (CHT), respectively, at three institutions in Nagasaki prefecture between 1997 and 2011. A multivariate analysis revealed that the development of abnormal lymphocytes in the peripheral blood of patients at relapse was less frequent after allo-SCT than after CHT (P<0.001). Furthermore, relapse with a new lesion only in the absence of the primary lesion was more frequent in allo-SCT (P=0.014). Lesions were more frequently observed in the central nervous systems of patients who relapsed with new lesions only (P=0.005). Thus, the clinical manifestation of relapsed ATL was slightly complex, especially in post-transplant patients. Our results emphasized the need to develop adoptive modalities for early and accurate diagnoses of relapsed ATL.

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Acknowledgements

We thank the hematologists at the Department of Hematology, Atomic Bomb Disease and Hibakusya Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, for the diagnosis and treatment of patients with ATL. This study was supported in part by a Grant-in-Aid from the Ministry of Health and Welfare of Japan and a Grant-in-Aid from the Ministry of Education, Culture, Sports, Science and Technology of Japan.

Author Contributions

HI, JT and Y Miyazaki conceived and designed the study; HI, H Taniguchi, JM and Y Miyazaki collected the data; HI and Y Miyazaki analyzed the data; HI, SH and Y Miyazaki performed the statistical analyses; HI and Y Miyazaki wrote the manuscript and created the figures and tables; and all authors critically reviewed the manuscript and read and approved the final version.

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Authors and Affiliations

  1. Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki city, Nagasaki, Japan

    H Itonaga, Y Sawayama, J Taguchi, K Ando, D Imanishi, Y Imaizumi, T Hata & Y Miyazaki

  2. Department of Hematology, Sasebo City General Hospital, Sasebo, Japan

    H Itonaga, H Taniguchi, S Sato & Y Moriuchi

  3. Department of Nursing, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

    S Honda

  4. Department of Internal Medicine, National Hospital Organization Nagasaki Medical Center, Ohmura, Japan

    J Makiyama, E Matsuo & S Yoshida

  5. Department of Clinical Laboratory Sciences, Laboratory of Hematoimmunology, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Nishihara, Okinawa, Japan

    T Fukushima

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  1. H Itonaga
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Correspondence to Y Sawayama.

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Itonaga, H., Sawayama, Y., Taguchi, J. et al. Characteristic patterns of relapse after allogeneic hematopoietic SCT for adult T-cell leukemia–lymphoma: a comparative study of recurrent lesions after transplantation and chemotherapy by the Nagasaki Transplant Group. Bone Marrow Transplant 50, 585–591 (2015). https://doi.org/10.1038/bmt.2014.308

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