title: Allogeneic bone marrow transplantation from unrelated human T-cell leukemia virus-I-negative donors for adult T-cell leukemia/lymphoma: retrospective analysis of data from the Japan Marrow Donor Program.
abstract: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) from an HLA-matched related donor has been suggested to improve the poor prognosis of adult T-cell leukemia/lymphoma (ATLL). However, the infusion of HTLV-I-infected cells from HTLV-I-positive related donors could lead to the development of donor-derived ATLL under immunosuppressive conditions. Although most ATLL patients lack a suitable HLA-matched related donor and require an HTLV-I-negative unrelated donor, little information is currently available regarding the outcome of unrelated bone marrow transplantation (UBMT) for ATLL. To evaluate the role of UBMT in treating ATLL, we retrospectively analyzed data from 33 patients with ATLL treated by UBMT through the Japan Marrow Donor Program (JMDP). Overall survival (OS), progression-free survival, and cumulative incidence of disease progression and progression-free mortality at 1 year after UBMT were 49.5%, 49.2%, 18.6%, and 32.3%, respectively. Multivariate analysis identified recipient age as an independent prognostic factor for OS (P = .044). Patients age >or=50 years who showed nonremission at transplantation tended to have higher rates of treatment-related mortality. Our observations suggest that UBMT could represent a feasible treatment option for ATLL patients and warrant further investigation based on these risk factors.
authors.affiliation: Department of Hematology, Hamanomachi General Hospital, Fukuoka, Japan. kojikato@umich.edu
authors.forename: Koji
authors.initials: K
authors.lastname: Kato
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kanda
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Eto
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Muta
authors.forename: Hisashi
authors.initials: H
authors.lastname: Gondo
authors.forename: Shuichi
authors.initials: S
authors.lastname: Taniguchi
authors.forename: Tsunefumi
authors.initials: T
authors.lastname: Shibuya
authors.forename: Atae
authors.initials: A
authors.lastname: Utsunomiya
authors.forename: Takakazu
authors.initials: T
authors.lastname: Kawase
authors.forename: Shunichi
authors.initials: S
authors.lastname: Kato
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Morishima
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Kodera
authors.forename: Mine
authors.initials: M
authors.lastname: Harada
mesh_terms: D000328:Adult; D016026:Bone Marrow Transplantation; D005260:Female; D006085:Graft Survival; D006086:Graft vs Host Disease; D020544:Graft vs Leukemia Effect / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation; D015368:Human T-lymphotropic virus 1 / Q000472:pathogenicity*; D006801:Humans; D007564:Japan; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D014184:Transplantation, Homologous