Promising approach for aggressive NK cell leukaemia with allogeneic haematopoietic cell transplantation.
OBJECTIVE
Aggressive natural killer cell leukaemia (ANKL) is a malignant disorder of mature NK cells with a poor prognosis, for which no effective therapeutic approach has been established. We investigated the role of allogeneic haematopoietic cell transplantion (allo-HCT) in ANKL.


METHODS
Three patients with ANKL received allo-HCT and seven did not. Epstein-Barr virus (EBV) viral load (VL) of the whole blood was measured with real-time quantitative polymerase chain reaction.


RESULTS
We transplanted three patients using a myeloablative conditioning regimen with human leucocyte antigen (HLA) two-loci mismatched cord blood (n = 2), or HLA-matched sibling bone marrow (n = 1). In one patient, a second transplantation from the haploidentical mother was also performed at relapse. No patients were in complete remission (CR) at the time of conditioning. After allo-HCT, all three achieved and maintained CR. One died from sepsis and the other relapsed, received the second transplantation and achieved a second CR. EBV VL was quite high in all three at presentation and its significant reduction was observed after allo-HCT. Although their backgrounds were not different from those without allo-HCT, patients with allo-HCT had a better outcome.


CONCLUSIONS
Allo-HCT might be a promising therapy for ANKL with curative potential.
Ito
Toshiro
T
Division of Hematology, Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Makishima
Hideki
H
Nakazawa
Hideyuki
H
Kobayashi
Hikaru
H
Shimodaira
Shigetaka
S
Nakazawa
Yozo
Y
Kitano
Kiyoshi
K
Matsuda
Kazuyuki
K
Hidaka
Eiko
E
Ishida
Fumihiro
F
D000328:Adult; D016026:Bone Marrow Transplantation; D036101:Cord Blood Stem Cell Transplantation; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D004854:Herpesvirus 4, Human; D006801:Humans; D007694:Killer Cells, Natural; D007945:Leukemia, Lymphoid / Q000628:therapy*; D008297:Male; D016133:Polymerase Chain Reaction; D019172:Transplantation Conditioning / Q000379:methods; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D019562:Viral Load