Hematopoietic stem cell transplantation for natural killer-cell lineage neoplasms.
Neoplasms of natural killer (NK)-lineage are rare. Their prognosis is generally poor except for cases of solitary nasal NK-cell lymphoma. The NK-cell Tumor Study Group performed a survey in Japan on patients diagnosed between 1994 and 1998. Of 228 patients selected for analysis, 40 underwent HSCT (15 allografts and 25 autografts). The underlying diseases were myeloid/NK cell precursor acute leukemia (n = 4), blastic NK-cell lymphoma (n = 11), aggressive NK-cell leukemia (n = 3), and nasal-type extranodal NK-cell lymphoma (n = 22). At the time of HSCT, 22 patients were in complete remission (CR), 11 were in relapse, and seven were primary refractory. All patients received myeloablative conditioning regimens including total-body irradiation. Sixteen died of disease progression, and six of treatment-related causes. Overall, 4-year survival was 39% with a median follow-up of 50 months; this was significantly better than that of patients who did not undergo HSCT (21%, P = 0.0003). For patients transplanted in CR, the 4-year overall survival was 68%, which was significantly better than that of patients who went into CR but did not undergo HSCT (P = 0.03). These findings suggest that the HSCT is a promising treatment strategy for NK-cell lineage.
Suzuki
R
R
Division of Molecular Medicine, Aichi Cancer Center, Kanokoden, Nagoya, Japan. rsuzuki@aichi-cc.jp
Suzumiya
J
J
Nakamura
S
S
Kagami
Y
Y
Kameoka
J-I
JI
Sakai
C
C
Mukai
H
H
Takenaka
K
K
Yoshino
T
T
Tsuzuki
T
T
Sugimori
H
H
Kawa
K
K
Kodera
Y
Y
Oshimi
K
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan; D007694:Killer Cells, Natural / Q000473:pathology*; D007938:Leukemia / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D008223:Lymphoma / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015996:Survival Rate; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous