title: Allogeneic stem-cell transplantation with reduced conditioning intensity as a novel immunotherapy and antiviral therapy for adult T-cell leukemia/lymphoma.
abstract: 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.
authors.affiliation: Institute for Clinical Research, National Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, Japan. jyokamur@nk-cc.go.jp
authors.forename: Jun
authors.initials: J
authors.lastname: Okamura
authors.forename: Atae
authors.initials: A
authors.lastname: Utsunomiya
authors.forename: Ryuji
authors.initials: R
authors.lastname: Tanosaki
authors.forename: Naokuni
authors.initials: N
authors.lastname: Uike
authors.forename: Shunro
authors.initials: S
authors.lastname: Sonoda
authors.forename: Mari
authors.initials: M
authors.lastname: Kannagi
authors.forename: Masao
authors.initials: M
authors.lastname: Tomonaga
authors.forename: Mine
authors.initials: M
authors.lastname: Harada
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Kimura
authors.forename: Masato
authors.initials: M
authors.lastname: Masuda
authors.forename: Fumio
authors.initials: F
authors.lastname: Kawano
authors.forename: Yuji
authors.initials: Y
authors.lastname: Yufu
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Hattori
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kikuchi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Saburi
mesh_terms: 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