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Allogeneic stem cell transplantation for patients with aggressive NK-cell leukemia

Bone Marrow Transplantation volume 56, pages 347–356 (2021)Cite this article

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Abstract

Aggressive NK-cell leukemia (ANKL) has a fulminant clinical course with a poor prognosis. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is currently the only curative treatment. Using the Japanese transplant registry data, the outcomes of 59 ANKL patients who underwent first allo-HSCT were analyzed. Twenty-nine patients received stem cells from cord blood (CB), 18 from peripheral blood, and 12 from bone marrow. At the time of transplant 21 patients had complete response (CR), and 7 partial response (PR), but 31 without response. The 1-year and 5-year overall survival (OS) were 33.9% and 27.3%, respectively. The 1-year cumulative incidences of relapse or progression was 55.5%, and that of non-relapse mortality was 12.1%. The OS was significantly better for patients with CR or PR at the time of allo-HSCT (P = 0.046), which was equivalent to that for patients who experienced primary induction failure at the time of allo-HSCT but achieved CR afterwards (40.6% versus 32.0% at 5 years; P = 0.95). Patients receiving CB had a significantly better OS than those receiving stem cells from others (37.3% versus 16.2% at 5 years; P = 0.04). Patients achieving event-free survival at 12 months after allo-HSCT had good outcomes with 5-year OS of 85.2%.

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Fig. 1: Outcomes of patients with aggressive NK-cell leukemia after allogeneic hematopoietic stem cell transplantation.
Fig. 2: The effect of each variable on probability of OS.
Fig. 3: The impact of EFS12 after allo-HSCT on the probability of OS.
Fig. 4: The effect of GVHD on the probability of OS.

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Acknowledgements

We thank all the physicians and data managers at the centers who contributed to gathering data on transplantation for the Transplant Registry Unified Management Program and all the members of the Data Management Committees of Japan Society for Hematopoietic Cell Transplantation. This work was supported in part by the Practical Research Project for Allergic Disease and Immunology (Research Technology of Medical Transplantation), Japan Agency for Medical Research and Development, AMED.

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Authors and Affiliations

  1. Department of Oncology and Hematology, Shimane University Hospital, Izumo, Japan

    Ayumi Fujimoto, Junji Suzumiya & Ritsuro Suzuki

  2. Department of Biomedical Laboratory Sciences, Shinshu University School of Medicine, Matsumoto, Japan

    Fumihiro Ishida

  3. Division of Hematology, Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan

    Fumihiro Ishida & Hitoshi Sakai

  4. Department of Hematology, National Cancer Center Hospital, Tokyo, Japan

    Koji Izutsu

  5. Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan

    Satoshi Yamasaki

  6. Medical Oncology Service, National Institute of Health, Bethesda, MD, USA

    Dai Chihara

  7. Department of Pediatrics, Yamagata University School of Medicine, Yamagata, Japan

    Tetsuo Mitsui

  8. Hematology Division, Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome Hospital, Tokyo, Japan

    Noriko Doki

  9. Department of Hematology, Nagano Red Cross Hospital, Nagano, Japan

    Hikaru Kobayashi

  10. Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Junya Kanda

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

    Takahiro Fukuda

  12. Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan

    Yoshiko Atsuta

  13. Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Yoshiko Atsuta

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  1. Ayumi Fujimoto
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Contributions

A.F. and R.S. designed the study. A.F. performed analyses and wrote the manuscript. All authors discussed the results, interpreted the data, and reviewed the manuscript.

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Correspondence to Ritsuro Suzuki.

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Fujimoto, A., Ishida, F., Izutsu, K. et al. Allogeneic stem cell transplantation for patients with aggressive NK-cell leukemia. Bone Marrow Transplant 56, 347–356 (2021). https://doi.org/10.1038/s41409-020-01009-8

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