title: Allogeneic haematopoietic stem cell transplantation as a promising treatment for natural killer-cell neoplasms.
abstract: The efficacy of allogeneic haematopoietic stem-cell transplantation (allo-HSCT) for natural killer (NK)-cell neoplasms is unknown. We investigated the results of allo-HSCT for NK-cell neoplasms between 1990 and 2003 through questionnaires. After reclassification by a haematopathologist, of 345 patients who underwent allo-HSCT for malignant lymphoma, 28 had NK-cell neoplasms (World Health Organization classification): extranodal NK/T-cell lymphoma (n=22), blastic NK-cell lymphoma (n=3), and aggressive NK-cell leukaemia (n=3). Twelve were chemosensitive and 16 chemorefractory. Twenty-two had matched-related donors. Stem-cell source was bone marrow in eight and mobilised peripheral blood in 20. Conditioning regimens were myeloablative (n=23) and non-myeloablative (n=5). Grade 2-4 acute graft-versus-host disease (GVHD) and chronic GVHD developed in 12 and 8 respectively. Eight died of disease progression, three of infection, two of acute GVHD, one of veno-occlusive disease, one of interstitial pneumonitis, and one of thrombotic microangiopathy. Two-year progression-free and overall survivals were 34% and 40% respectively (median follow-up, 34 months). All patients who did not relapse/progress within 10 months achieved progression-free survival (PFS) during the follow-up. In multivariate analysis, stem cell source (BM versus peripheral blood; relative risk 3.03), age (>or=40 years vs. <40 years; relative risk 2.85), and diagnoses (extranodal NK/T-cell lymphoma versus others; relative risk 3.94) significantly affected PFS. Allo-HSCT is a promising treatment for NK-cell neoplasms.
authors.affiliation: Haematopoietic Stem Cell Transplantation Unit, the National Cancer Centre Hospital and Department of Cell Therapy and Transplantation Medicine, University of Tokyo, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Murashige
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kami
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Kishi
authors.forename: Sung-Won
authors.initials: SW
authors.lastname: Kim
authors.forename: Masami
authors.initials: M
authors.lastname: Takeuchi
authors.forename: Kosei
authors.initials: K
authors.lastname: Matsue
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kanda
authors.forename: Makoto
authors.initials: M
authors.lastname: Hirokawa
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Kawabata
authors.forename: Tomoko
authors.initials: T
authors.lastname: Matsumura
authors.forename: Eiji
authors.initials: E
authors.lastname: Kusumi
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Hirabayashi
authors.forename: Koji
authors.initials: K
authors.lastname: Nagafuji
authors.forename: Ritsuro
authors.initials: R
authors.lastname: Suzuki
authors.forename: Kengo
authors.initials: K
authors.lastname: Takeuchi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Oshimi
mesh_terms: D000328:Adult; D016026:Bone Marrow Transplantation; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007694:Killer Cells, Natural / Q000276:immunology*; D016399:Lymphoma, T-Cell / Q000276:immunology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation; D016016:Proportional Hazards Models; D012306:Risk; D014184:Transplantation, Homologous