title: Characteristic patterns of relapse after allogeneic hematopoietic SCT for adult T-cell leukemia-lymphoma: a comparative study of recurrent lesions after transplantation and chemotherapy by the Nagasaki Transplant Group.
abstract: Allogeneic hematopoietic SCT (allo-SCT) is a promising therapy that may provide long-term durable remission for adult T-cell leukemia-lymphoma (ATL) patients; however, the incidence of relapse associated with ATL remains high. To determine the clinical features of these patients at relapse, we retrospectively analyzed tumor lesions in 30 or 49 patients who relapsed following allo-SCT or chemotherapy (CHT), respectively, at three institutions in Nagasaki prefecture between 1997 and 2011. A multivariate analysis revealed that the development of abnormal lymphocytes in the peripheral blood of patients at relapse was less frequent after allo-SCT than after CHT (P<0.001). Furthermore, relapse with a new lesion only in the absence of the primary lesion was more frequent in allo-SCT (P=0.014). Lesions were more frequently observed in the central nervous systems of patients who relapsed with new lesions only (P=0.005). Thus, the clinical manifestation of relapsed ATL was slightly complex, especially in post-transplant patients. Our results emphasized the need to develop adoptive modalities for early and accurate diagnoses of relapsed ATL.
authors.affiliation: 1] Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki city, Nagasaki, Japan [2] Department of Hematology, Sasebo City General Hospital, Sasebo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Itonaga
authors.affiliation: Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki city, Nagasaki, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Sawayama
authors.affiliation: Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki city, Nagasaki, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Taguchi
authors.affiliation: Department of Nursing, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Honda
authors.affiliation: Department of Hematology, Sasebo City General Hospital, Sasebo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Taniguchi
authors.affiliation: Department of Internal Medicine, National Hospital Organization Nagasaki Medical Center, Ohmura, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Makiyama
authors.affiliation: Department of Internal Medicine, National Hospital Organization Nagasaki Medical Center, Ohmura, Japan.
authors.forename: E
authors.initials: E
authors.lastname: Matsuo
authors.affiliation: Department of Hematology, Sasebo City General Hospital, Sasebo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Sato
authors.affiliation: Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki city, Nagasaki, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Ando
authors.affiliation: Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki city, Nagasaki, Japan.
authors.forename: D
authors.initials: D
authors.lastname: Imanishi
authors.affiliation: Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki city, Nagasaki, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Imaizumi
authors.affiliation: Department of Internal Medicine, National Hospital Organization Nagasaki Medical Center, Ohmura, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Yoshida
authors.affiliation: Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki city, Nagasaki, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Hata
authors.affiliation: Department of Hematology, Sasebo City General Hospital, Sasebo, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Moriuchi
authors.affiliation: Laboratory of Hematoimmunology, Department of Clinical Laboratory Sciences, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Nishihara, Okinawa, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Fukushima
authors.affiliation: Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki city, Nagasaki, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Miyazaki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D064591:Allografts; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007564:Japan; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000628:therapy; D008214:Lymphocytes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012008:Recurrence