Allogeneic Hematopoietic Stem Cell Transplantation Using Reduced-Intensity Conditioning for Adult T Cell Leukemia/Lymphoma: Impact of Antithymocyte Globulin on Clinical Outcome |
| |
| Affiliation: | 1. Stem Cell Transplantation Unit, National Cancer Center Hospital, Tokyo, Japan;2. Department of Hematology, National Kyushu Cancer Center, Fukuoka, Japan;3. Department of Hematology, Imamura Bun-in Hospital, Kagoshima, Japan;4. Department of Hematology, Oita Prefectural Hospital, Oita, Japan;5. Cancer Center, University of the Ryukyus, Okinawa, Japan;6. Department of Hematology, Molecular Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, School of Medicine, Nagasaki, Japan;7. Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan;8. Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan;9. Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan;10. Institute for Clinical Research, National Kyushu Cancer Center, Fukuoka, Japan;11. Department of Immunotherapeutics, Tokyo Medical and Dental University, Medical Research Division, Tokyo, Japan;12. Laboratory of Virus Immunology, Institute for Virus Research, Kyoto University, Kyoto, Japan |
| |
| Abstract: | ![]()
Allogeneic hematopoietic stem cell transplantation (HSCT) is an effective treatment for adult T cell leukemia/lymphoma (ATLL), but shows high mortality. We evaluated the feasibility of reduced-intensity transplantation using fludarabine and busulfan, with particular focus on the clinical impact of antithymocyte globulin (ATG) in the conditioning regimen. Fourteen elderly patients with aggressive ATLL were enrolled in the current study without ATG, and were compared to those in 15 patients who were treated similarly, but with ATG, in our previous study. Engraftment was prompt, and treatment was tolerable. Overall (OS) and progression-free survival (PFS) at 3 years were 36% and 31%, respectively. HTVL-1 proviral load became undetectable by the polymerase chain reaction in 62% of patients. Compared to the previous study with ATG, complete donor chimera was significantly delayed. Although early relapse tended to be decreased, OS or PFS was not improved significantly. Analysis of combined data from both our current and previous studies disclosed that grade I-II acute GVHD was the only factor that favorably affected OS and PFS. These data suggested the presence of a graft-versus-ATLL effect and the feasibility of a transplant procedure without ATG in elderly ATLL patients, but could not demonstrate the clinical benefit of incorporating ATG. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
