Early application of related SCT might improve clinical outcome in adult T-cell leukemia/lymphoma

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Allogeneic hematopoietic SCT (allo-HSCT) is a curative treatment for aggressive adult T-cell leukemia/lymphoma (ATLL). Considering the dismal prognosis associated with conventional chemotherapies, early application of allo-HSCT might be beneficial for patients with ATLL. However, no previous study has addressed the optimal timing of allo-HSCT from related donors. Hence, to evaluate the impact of timing of allo-HSCT for patients with ATLL, we retrospectively analyzed data from patients with ATLL who received an allo-HSCT from a related donor. The median age was 52 years. Patients were grouped according to the interval from diagnosis to allo-HSCT: early transplant group, <100 days, n=72; late transplant group, 100 days, n=428. The corresponding constituents of disease status were not statistically different between the two groups (P=0.11). The probability of OS in the early transplant group was significantly higher than that in the late transplant group (4-year OS, 49.3% vs 31.2%). Multivariate analysis revealed that late allo-HSCT was an unfavorable prognostic factor for OS (hazard ratio, 1.46; 95% confidence interval (CI), 1.01–2.11; P=0.04). Despite the limitations of a retrospective study, it might be acceptable to consider early application of allo-HSCT for ATLL.

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  1. 1

    Ishitsuka K, Tamura K . Human T-cell leukaemia virus type I and adult T-cell leukaemia-lymphoma. Lancet Oncol 2014; 15: e517–e526.

  2. 2

    Tsukasaki K, Hermine O, Bazarbachi A, Ratner L, Ramos JC, Harrington W Jr et al. Definition, prognostic factors, treatment, and response criteria of adult T-cell leukemia-lymphoma: a proposal from an international consensus meeting. J Clin Oncol 2009; 27: 453–459.

  3. 3

    Katsuya H, Yamanaka T, Ishitsuka K, Utsunomiya A, Sasaki H, Hanada S et al. Prognostic index for acute- and lymphoma-type adult T-cell leukemia/lymphoma. J Clin Oncol 2012; 30: 1635–1640.

  4. 4

    Tsukasaki K, Utsunomiya A, Fukuda H, Shibata T, Fukushima T, Takatsuka Y et al. VCAP-AMP-VECP compared with biweekly CHOP for adult T-cell leukemia-lymphoma: Japan Clinical Oncology Group Study JCOG9801. J Clin Oncol 2007; 25: 5458–5464.

  5. 5

    Yamada Y, Tomonaga M, Fukuda H, Hanada S, Utsunomiya A, Tara M et al. A new G-CSF-supported combination chemotherapy, LSG15, for adult T-cell leukaemia-lymphoma: Japan Clinical Oncology Group Study 9303. Br J Haematol 2001; 113: 375–382.

  6. 6

    Fukushima T, Nomura S, Shimoyama M, Shibata T, Imaizumi Y, Moriuchi Y et al. Japan Clinical Oncology Group (JCOG) prognostic index and characterization of long-term survivors of aggressive adult T-cell leukaemia-lymphoma (JCOG0902A). Br J Haematol 2014; 166: 739–748.

  7. 7

    Kanda J, Hishizawa M, Utsunomiya A, Taniguchi S, Eto T, Moriuchi Y et al. Impact of graft-versus-host disease on outcomes after allogeneic hematopoietic cell transplantation for adult T-cell leukemia: a retrospective cohort study. Blood 2012; 119: 2141–2148.

  8. 8

    Ishida T, Hishizawa M, Kato K, Tanosaki R, Fukuda T, Taniguchi S et al. Allogeneic hematopoietic stem cell transplantation for adult T-cell leukemia-lymphoma with special emphasis on preconditioning regimen: a nationwide retrospective study. Blood 2012; 120: 1734–1741.

  9. 9

    Hishizawa M, Kanda J, Utsunomiya A, Taniguchi S, Eto T, Moriuchi Y et al. Transplantation of allogeneic hematopoietic stem cells for adult T-cell leukemia: a nationwide retrospective study. Blood 2010; 116: 1369–1376.

  10. 10

    Atsuta Y, Suzuki R, Yoshimi A, Gondo H, Tanaka J, Hiraoka A et al. Unification of hematopoietic stem cell transplantation registries in Japan and establishment of the TRUMP System. Int J Hematol 2007; 86: 269–274.

  11. 11

    Przepiorka D, Weisdorf D, Martin P, Klingemann HG, Beatty P, Hows J et al. 1994 Consensus Conference on Acute GVHD Grading. Bone Marrow Transplant 1995; 15: 825–828.

  12. 12

    Fine JP, Gray RJ . A proportional hazards model for the subdistribution of a competing risk. J Am Stat Assoc 1999; 94: 496–509.

  13. 13

    Kanda Y . Investigation of the freely available easy-to-use software 'EZR' for medical statistics. Bone Marrow Transplant 2013; 48: 452–458.

  14. 14

    Stolzel F, Platzbecker U, Mohr B, Rollig C, Middeke JM, Thiede C et al. Early intervention with allogeneic hematopoietic cell transplantation during chemotherapy-induced aplasia in patients with high-risk acute myeloid leukemia. Leukemia 2013; 27: 2068–2072.

  15. 15

    Mak V, Hamm J, Chhanabhai M, Shenkier T, Klasa R, Sehn LH et al. Survival of patients with peripheral T-cell lymphoma after first relapse or progression: spectrum of disease and rare long-term survivors. J Clin Oncol 2013; 31: 1970–1976.

  16. 16

    Fukushima T, Itonaga H, Moriuchi Y, Yoshida S, Taguchi J, Imaizumi Y et al. Feasibility of cord blood transplantation in chemosensitive adult T-cell leukemia/lymphoma: a retrospective analysis of the Nagasaki Transplantation Network. Int J Hematol 2013; 97: 485–490.

  17. 17

    Nakamura T, Oku E, Nomura K, Morishige S, Takata Y, Seki R et al. Unrelated cord blood transplantation for patients with adult T-cell leukemia/lymphoma: experience at a single institute. Int J Hematol 2012; 96: 657–663.

  18. 18

    Kato K, Choi I, Wake A, Uike N, Taniguchi S, Moriuchi Y et al. Treatment of patients with adult T cell leukemia/lymphoma with cord blood transplantation: a Japanese nationwide retrospective survey. Biol Blood Marrow Transplant 2014; 20: 1968–1974.

  19. 19

    Luznik L, O'Donnell PV, Symons HJ, Chen AR, Leffell MS, Zahurak M et al. HLA-haploidentical bone marrow transplantation for hematologic malignancies using nonmyeloablative conditioning and high-dose, posttransplantation cyclophosphamide. Biol Blood Marrow Transplant 2008; 14: 641–650.

  20. 20

    Bashey A, Zhang X, Sizemore CA, Manion K, Brown S, Holland HK et al. T-cell-replete HLA-haploidentical hematopoietic transplantation for hematologic malignancies using post-transplantation cyclophosphamide results in outcomes equivalent to those of contemporaneous HLA-matched related and unrelated donor transplantation. J Clin Oncol 2013; 31: 1310–1316.

  21. 21

    Fujiwara H, Ozaki A, Yoshimitsu M, Hamada H, Masamoto I, Matsushita K et al. Allogeneic stem cell transplantation for refractory adult T-cell leukemia using a non-T-cell-depleted HLA-incompatible family donor graft, with reference to the grown-up child donor to parent recipient setting: report of a pilot study. Int J Hematol 2008; 87: 319–326.

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This work was supported by grants from the Japanese Ministry of Health, Labour and Welfare. We thank the medical, nursing, data-processing, laboratory and clinical staff at the participating centers for their important contributions to this study and their dedicated care of the patients.

Author contributions

SF participated in research design, data analysis and writing of the paper; HF participated in research design, data analysis and writing of the paper; NN, AW and YI participated in research design; TF, MH, YM, TI and YA gathered the data; AU participated in research design and writing of the paper. All authors approved the submission of this study.

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Correspondence to S Fuji.

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The authors declare no conflict of interest.

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Fuji, S., Fujiwara, H., Nakano, N. et al. Early application of related SCT might improve clinical outcome in adult T-cell leukemia/lymphoma. Bone Marrow Transplant 51, 205–211 (2016) doi:10.1038/bmt.2015.265

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