title: High level of serum soluble interleukin-2 receptor at transplantation predicts poor outcome of allogeneic stem cell transplantation for adult T cell leukemia.
abstract: The prognosis for adult T cell leukemia/lymphoma (ATL) is very poor, and only allogeneic hematopoietic stem cell transplantation (allo-SCT) has been considered to be a curative treatment for ATL. In this study, we retrospectively analyzed data for patients who had received allo-SCT for ATL in Hokkaido, the northernmost island of Japan, to determine prognostic factors. Fifty-six patients with a median age of 57 years received allo-SCT. Twenty-eight (50.0%) patients had acute type and 22 (46.4%) had lymphoma type. Twenty-three (41.1%) patients received allo-SCT in complete remission (CR), whereas the others were in non-CR. Seventeen (30.4%) patients received myeloablative conditioning and the others received reduced-intensity conditioning. With a median follow-up period of 48 months (range, 17 to 134 months), 1-year overall survival (OS) and 5-year OS rates were 55.4% and 46.1%, respectively. The survival curve reached a plateau at 22 months after stem cell transplantation (SCT). Male sex, high level of serum soluble interleukin-2 receptor (sIL-2R) at SCT, and non-CR at SCT were determined to be significant risk factors for OS. A high level of sIL-2R at SCT was a risk factor for poor OS in patients with non-CR at SCT by univariate analysis (P = .02), and it remained significant after adjustment by sex (hazard ratio, 2.73 [95% confidence interval, 1.07 to 7.90]). A high level of sIL-2R at SCT was also determined to be a risk factor for disease progression (P = .02). This region-wide study showed encouraging results for survival after allo-SCT for ATL and demonstrated for the first time that a high level of sIL-2R at SCT predicts worse SCT outcome.
authors.affiliation: Department of Hematology, Hokkaido University, Sapporo, Japan. Electronic address: shigema@med.hokudai.ac.jp.
authors.forename: Akio
authors.initials: A
authors.lastname: Shigematsu
authors.affiliation: Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Kobayashi
authors.affiliation: First Department of Internal Medicine, Sapporo Medical University, Sapporo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yasui
authors.affiliation: Third Department of Internal Medicine, Asahikawa Medical School, Asahikawa, Japan.
authors.forename: Motohiro
authors.initials: M
authors.lastname: Shindo
authors.affiliation: Department of Hematology, Asahikawa City Hospital, Asahikawa, Japan.
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Kakinoki
authors.affiliation: Department of Hematology and Oncology, Asahikawa Red Cross Hospital, Asahikawa, Japan.
authors.forename: Kyuhei
authors.initials: K
authors.lastname: Koda
authors.affiliation: Fourth Department of Internal Medicine, Sapporo Medical University, Sapporo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Iyama
authors.affiliation: Department of Hematology and Oncology, Steel Memorial Muroran Hospital, Muroran, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuroda
authors.affiliation: Department of Internal Medicine, Hakodate Municipal Hospital, Hakodate, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Tsutsumi
authors.affiliation: Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Imamura
authors.affiliation: Department of Hematology, Hokkaido University, Sapporo, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Teshima
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000097:blood* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D015375:Receptors, Interleukin-2 / Q000097:blood*; D016019:Survival Analysis; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D015375:Receptors, Interleukin-2
keywords: Adult T cell leukemia; Allogeneic stem cell transplantation; Prognostic factor; Region-wide study; Soluble interleukin-2 receptor