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A retrospective analysis of haplo-identical HLA-mismatch hematopoietic transplantation without posttransplantation cyclophosphamide for GVHD prophylaxis in patients with adult T-cell leukemia–lymphoma

Bone Marrow Transplantation volume 54, pages 1266–1274 (2019)Cite this article

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Abstract

Currently, allogeneic hematopoietic stem cell transplantation (allo-HCT) is the only available curative modality for patients with adult T-cell leukemia–lymphoma (ATL). When used in conjunction with posttransplantation cyclophosphamide (PTCY) for graft-versus-host disease prophylaxis, allo-HCT from an HLA haplo-identical donor yields promising outcomes for many diseases other than ATL. However, appropriate comparisons with other donor sources, especially cord blood and conventional HLA haplo-identical donors, are needed to validate the safety and efficacy of this modality. In this study, we retrospectively evaluated the outcome of allo-HCT without PTCY in patients with ATL registered in the Japan Society for Hematopoietic Cell Transplantation TRUMP database between 1985 and 2015. During that period, 46 patients received allo-HCT without PTCY and survivors were followed for a median of 2316.5 days (range: 220–3884 days). Although the estimated 1- and 5-year overall survival rates of the entire cohort were 34.5% and 17.7%, respectively, the cumulative 1- and 5-year non-ATL mortality rates of 41.3% and 55.8%, respectively, were high. The results of our study will serve as a platform for discussions of the safety and efficacy of haplo-HCT for future clinical trials in patients with ATL.

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Acknowledgements

We thank all the physicians and data managers at the participating institutions, who contributed valuable data on transplantation for ATL to the JSHCT. We also thank all members of the data management committees of the JSHCT.

ATL Working Group of the Japan Society for Hematopoietic Cell Transplantation

Koji Kato, Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan. Takashi Ishida, Division of Hematology and Oncology, Department of Internal Medicine, Iwate Medical University School of Medicine, Morioka, Japan. Atae Utsunomiya, Department of Hematology, Imamura General Hospital, Kagoshima, Japan. Junji Suzumiya, Innovative Cancer Center/Oncology-Hematology, Shimane University Hospital, Izumo, Japan. Yoshifusa Takatsuka, Department of Hematology, Izuro Imamura Hospital, Kagoshima, Japan. Tomomi Tobai, Department of Internal Medicine III, Division of Hematology and Cell Therapy, Yamagata University Faculty of Medicine, Yamagata, Japan. Koichi Nakase, Division of Hematology, Ehime Prefectural Central Hospital, Matsuyama, Japan. Yuichiro Nawa, Division of Hematology, Ehime Prefectural Central Hospital, Matsuyama, Japan. Masakatsu Hishizawa, Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan. Takuya Fukushima, Division of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology, Second Department of Internal Medicine, Graduate School of Medicine, University of the Ryukyus, Nishihara, Japan. Laboratory of Hematoimmunology, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Nishihara, Japan. Masato Masuda, Division of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology, Second Department of Internal Medicine, Graduate School of Medicine, University of the Ryukyus, Nishihara, Japan. Cancer Centre, University of the Ryukyus, Nishihara, Japan. Atsushi Wake, Department of Hematology, Toranomon Hospital Kajigaya, Kawasaki, Japan. Choi Ilseung, Department of Hematology, National Kyushu Cancer Center, Fukuoka, Japan. Yoshitaka Asakura, Department of Hematology, Okinawa Red Cross Hospital, Naha, Japan. Nobuaki Nakano, Department of Hematology, Imamura General Hospital, Kagoshima, Japan. Hiroshi Fujiwara, Department of Immuno-gene therapy, Center for Comprehensive Cancer Immunotherapy, Mie University Graduate School of Medicine, Tsu, Japan. Shinichiro Machida, Department of Hematology and Oncology, Tokai University School of Medicine, Isehara, Japan. Yasushi Sawayama, Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan. Kohei Tada, Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan. Yoshitaka Inoue, Department of Hematology, Kumamoto University Hospital, Kumamoto, Japan. Kazunori Imada, Department of Hematology, Osaka Red Cross Hospital, Osaka, Japan. Isao Yoshida, Department of Hematologic Oncology, Shikoku Cancer Center, Matsuyama, Japan. Makoto Yoshimitsu, Department of Hematology and Immunology, Kagoshima University Hospital, Kagoshima, Japan. Shigeo Fuji, Department of Hematology, Osaka International Cancer Center, Osaka, Japan. Takahiro Fukuda, Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan. Takero Shindo, Department of Hematology/Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan. Masahito Tokunaga, Department of Hematology, Imamura General Hospital, Kagoshima, Japan. Hiroyuki Muranushi, Department of Hematology/Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan. Satoko Morishima, Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology (Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, Nishihara, Japan. Shohei Tomori, Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology (Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, Nishihara, Japan. Tomoki Iemura, Department of Hematology/Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan.

Author contributions

MY, AU, SF, HF, TF, and KK designed the research, organized the project, and wrote the paper. MY performed the statistical analyses. H Ogawa, YT, KI, AY, H Okumura, KI, AN, TE, AY, KM, J Tsukada, J Tanaka, and YA gathered the data. All authors contributed to the final version of the manuscript and have approved it for submission for publication.

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Authors and Affiliations

  1. Department of Hematology and Immunology, Kagoshima University Hospital, Kagoshima, Japan

    Makoto Yoshimitsu & Kenji Ishitsuka

  2. Department of Hematology, Imamura General Hospital, Kagoshima, Japan

    Atae Utsunomiya & Yoshifusa Takatsuka

  3. Department of Hematology, Osaka International Cancer Center, Osaka, Japan

    Shigeo Fuji

  4. Department of Hematology, Clinical Immunology and Infectious Diseases, Graduate School of Medicine, Ehime University, Ehime, Japan

    Hiroshi Fujiwara

  5. Department of Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan

    Takahiro Fukuda

  6. Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan

    Hiroyasu Ogawa

  7. Department of Hematology, Chiba Aoba Municipal Hospital, Chiba, Japan

    Akira Yokota

  8. Department of Internal Medicine (Hematology), Toyama Prefectural Central Hospital, Toyama, Japan

    Hirokazu Okumura

  9. Department of Hematology and Oncology, Kansai Medical University Medical Center, Osaka, Japan

    Kazuyoshi Ishii

  10. Department of Hematology, Wakayama Medical University, Wakayama, Japan

    Akinori Nishikawa

  11. Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan

    Tetsuya Eto

  12. Department of Hematology, Kokura Memorial Hospital, Fukuoka, Japan

    Akihito Yonezawa

  13. Department of Hematology, National Kyushu Cancer Center, Fukuoka, Japan

    Kaname Miyashita

  14. Department of Hematology, University of Occupational and Environmental Health, Fukuoka, Japan

    Junichi Tsukada

  15. Department of Hematology, Tokyo Women’s Medical University, Tokyo, Japan

    Junji Tanaka

  16. Japanese Data Center for Hematopoietic Cell Transplantation, Aichi, Japan

    Yoshiko Atsuta

  17. Nagoya University Graduate School of Medicine, Aichi, Japan

    Yoshiko Atsuta

  18. Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan

    Koji Kato

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  1. Makoto Yoshimitsu
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  2. Atae Utsunomiya
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Correspondence to Makoto Yoshimitsu.

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Yoshimitsu, M., Utsunomiya, A., Fuji, S. et al. A retrospective analysis of haplo-identical HLA-mismatch hematopoietic transplantation without posttransplantation cyclophosphamide for GVHD prophylaxis in patients with adult T-cell leukemia–lymphoma. Bone Marrow Transplant 54, 1266–1274 (2019). https://doi.org/10.1038/s41409-018-0400-5

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