Allogeneic transplantation for adult T‐cell leukemia/lymphoma in adolescent and young adults and young patients: A nationwide retrospective study by the ATL working group of the Japan society for transplantation and cellular therapy

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) provides durable remission for patients with adult T-cell leukemia/lymphoma (ATL); however, few studies have focused on post-transplant outcomes in ATL patients ≤49 years. To clarify prognostic factors in ATL among patients <40 years (adolescents and young adult [AYA]; n = 73) and 40-49 years (Young; n = 330), we conducted a nationwide retrospective study. Estimated 3-year overall survival (OS) rates were 61.8% and 43.1% in AYA and Young patients, respectively (p = 0.005). In the multivariate analysis, Young patients showed worse OS (Hazard ratio (HR) [95% confidential interval] 1.62 [1.10-2.39], p = 0.015), chronic graft-versus-host disease (GVHD)-free and relapse-free survival (CRFS) (HR 1.54 [1.10-2.14], p = 0.011), and GVHD-free and relapse-free survival (GRFS) (HR 1.40 [1.04-1.88], p = 0.026) than AYA patients. No significant differences were observed in OS, CRFS, or GRFS between the myeloablative conditioning (MAC) and reduced-intensity conditioning (RIC) regimens; however, non-relapse mortality was significantly lower in patients with the RIC regimen than those with the MAC regimen (HR 0.46 [0.24-0.86], p = 0.015). In summary, OS was worse in Young patients than in AYA patients in the allo-HSCT setting for ATL. Furthermore, the RIC regimen has potential as an alternative treatment option for ATL patients ≤49 years.

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Journal
Hematological Oncology
Published
2024-10-04
DOI
https://doi.org/10.1002/hon.3315
Citations
4
Primary Topic
T-cell and Retrovirus Studies
Type
article
Field-Weighted Citation Impact
0.96

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article

Allogeneic transplantation for adult T‐cell leukemia/lymphoma in adolescent and young adults and young patients: A nationwide retrospective study by the ATL working group of the Japan society for transplantation and cellular therapy

Hidehiro Itonaga, Takahiro Fukuda, Naoyuki Uchida, Yoshinobu Kanda et al.
4 citations
Hematological Oncology
T-cell and Retrovirus Studies
0.96
article

Allogeneic transplantation for adult T‐cell leukemia/lymphoma in adolescent and young adults and young patients: A nationwide retrospective study by the ATL working group of the Japan society for transplantation and cellular therapy

Hidehiro Itonaga, Takahiro Fukuda, Naoyuki Uchida, Yoshinobu Kanda, Koji Kato, Nobuaki Nakano, Machiko Fujioka, Toshiro Kawakita, Yasuo Mori, Shigeo Fuji, Takashi Tanaka, Tetsuya Eto, Makoto Yoshimitsu, Hirohisa Nakamae, Satoko Morishima, Masao Ogata, Takeharu Kato, Takuya Fukushima, Yoshiko Atsuta
article en
4 citations

Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) provides durable remission for patients with adult T-cell leukemia/lymphoma (ATL); however, few studies have focused on post-transplant outcomes in ATL patients ≤49 years. To clarify prognostic factors in ATL among patients <40 years (adolescents and young adult [AYA]; n = 73) and 40-49 years (Young; n = 330), we conducted a nationwide retrospective study. Estimated 3-year overall survival (OS) rates were 61.8% and 43.1% in AYA and Young patients, respectively (p = 0.005). In the multivariate analysis, Young patients showed worse OS (Hazard ratio (HR) [95% confidential interval] 1.62 [1.10-2.39], p = 0.015), chronic graft-versus-host disease (GVHD)-free and relapse-free survival (CRFS) (HR 1.54 [1.10-2.14], p = 0.011), and GVHD-free and relapse-free survival (GRFS) (HR 1.40 [1.04-1.88], p = 0.026) than AYA patients. No significant differences were observed in OS, CRFS, or GRFS between the myeloablative conditioning (MAC) and reduced-intensity conditioning (RIC) regimens; however, non-relapse mortality was significantly lower in patients with the RIC regimen than those with the MAC regimen (HR 0.46 [0.24-0.86], p = 0.015). In summary, OS was worse in Young patients than in AYA patients in the allo-HSCT setting for ATL. Furthermore, the RIC regimen has potential as an alternative treatment option for ATL patients ≤49 years.

Hematological OncologyVol. 42(6)
Kyushu University (JP), Jichi Medical University (JP), Aichi Medical University (JP), University of the Ryukyus (JP), Sasebo City General Hospital (JP), Kyushu University Hospital (JP), Hamanomachi Hospital (JP), Kagoshima University Hospital (JP), Imamura Hospital (JP), Osaka International Cancer Institute (JP), Oita University Hospital (JP), The Japanese Data Center for Hematopoietic Cell Transplantation (JP), Nagasaki University Hospital (JP), Kumamoto Medical Center (JP), Osaka City University Hospital (JP), Toranomon Hospital (JP), Osaka Metropolitan University (JP)
Takeda Science Foundation, Japan Society for the Promotion of Science
Good health and well-being
Openalex Percentile: Top 24%
T-cell and Retrovirus Studies
0.96
DOISourceOpenAlex
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