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

• Published in: Bone marrow transplantation (Basingstoke) Vol. 51; no. 2; pp. 205 - 211
• Main Authors: Fuji, S, Fujiwara, H, Nakano, N, Wake, A, Inoue, Y, Fukuda, T, Hidaka, M, Moriuchi, Y, Miyamoto, T, Uike, N, Taguchi, J, Eto, T, Tomoyose, T, Kondo, T, Yamanoha, A, Ichinohe, T, Atsuta, Y, Utsunomiya, A
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-02-2016; Nature Publishing Group
• Subjects: 631/67/1990/291/1621/1916; 692/308; Adolescent; Adult; Aged; Allografts; Bone marrow; Cell Biology; Chemotherapy; Clinical outcomes; Confidence intervals; Female; Follow-Up Studies; Health aspects; Hematology; Hematopoietic Stem Cell Transplantation; Humans; Internal Medicine; Leukemia; Leukemia-Lymphoma, Adult T-Cell - diagnosis; Leukemia-Lymphoma, Adult T-Cell - mortality; Leukemia-Lymphoma, Adult T-Cell - therapy; Lymphocytes T; Lymphoma; Male; Medicine; Medicine & Public Health; Middle Aged; Multivariate analysis; original-article; Patients; Physiological aspects; Prognosis; Public Health; Registries; Retrospective Studies; Statistical analysis; Stem cell transplantation; Stem Cells; T cells; Time Factors; Japan
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/bmt.2015.265

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.