Allogeneic stem-cell transplantation with reduced conditioning intensity as a novel immunotherapy and antiviral therapy for adult T-cell leukemia/lymphoma.
Sixteen patients with adult T-cell leukemia/lymphoma (ATL) who were all over 50 years of age underwent allogeneic stem cell transplantation with reduced-conditioning intensity (RIST) from HLA-matched sibling donors after a conditioning regimen consisting of fludarabine (180 mg/m2), busulfan (8 mg/kg), and rabbit antithymocyte globulin (5 mg/kg). The observed regimen-related toxicities and nonhematologic toxicities were all found to be acceptable. Disease relapse was the main cause of treatment failure. Three patients who had a relapse subsequently responded to a rapid discontinuation of the immunosuppressive agent and thereafter achieved another remission. After RIST, the human T-cell leukemia virus type 1 (HTLV-1) proviral load became undetectable in 8 patients. RIST is thus considered to be a feasible treatment for ATL. Our data also suggest the presence of a possible graft-versus-ATL effect; an anti-HTLV-1 activity was also found to be associated with this procedure.
Okamura
Jun
J
Institute for Clinical Research, National Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, Japan. jyokamur@nk-cc.go.jp
Utsunomiya
Atae
A
Tanosaki
Ryuji
R
Uike
Naokuni
N
Sonoda
Shunro
S
Kannagi
Mari
M
Tomonaga
Masao
M
Harada
Mine
M
Kimura
Nobuhiro
N
Masuda
Masato
M
Kawano
Fumio
F
Yufu
Yuji
Y
Hattori
Hiroyoshi
H
Kikuchi
Hiroshi
H
Saburi
Yoshio
Y
D000368:Aged; D005260:Female; D015368:Human T-lymphotropic virus 1 / Q000502:physiology; D006801:Humans; D007167:Immunotherapy; D007700:Kinetics; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000276:immunology / Q000628:therapy* / Q000821:virology; D008297:Male; D008875:Middle Aged; D033581:Stem Cell Transplantation; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous