Allogeneic Hematopoietic Cell Transplantation for Aggressive NK Cell Leukemia. A Center for International Blood and Marrow Transplant Research Analysis.
Aggressive NK cell leukemia (ANKL) is an exceedingly rare form of leukemia and carries a poor prognosis, with a median survival of only 2 months. Using the Center for International Blood and Marrow Transplant Research database, we evaluated outcomes of allogeneic hematopoietic cell transplantation (alloHCT) in patients with ANKL. Twenty-one patients with a centrally confirmed diagnosis of ANKL were included. Median patient age was 42 years and 15 patients (71%) were Caucasian. Fourteen patients (67%) were in complete remission (CR) at the time of alloHCT, and 5 patients had active disease. Median follow-up of survivors was 25 months (range, 12 to 116). The 2-year estimates of nonrelapse mortality, relapse/progression, progression-free (PFS), and overall survival (OS) were 21%, 59%, 20%, and 24%, respectively. The 2-year PFS of patients in CR at the time of alloHCT was significantly better than that of patients with active disease at transplantation (30% versus 0%; P = .001). The 2-year OS in similar order was 38% versus 0% (P < .001). In conclusion, this registry analysis that included majority non-Asian patient population shows that alloHCT can provide durable disease control in a subset of ANKL patients. Achieving CR before transplantation appears to be a prerequisite for successful transplantation outcomes.
Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin. Electronic address: mhamadani@mcw.edu.
Mehdi
M
Hamadani
Osborn Hematopoietic Malignancy and Transplantation Program, West Virginia University, Morgantown, West Virginia.
Abraham S
AS
Kanate
Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
Alyssa
A
DiGilio
Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin.
Kwang Woo
KW
Ahn
Section of Hematology/Oncology, The University of Chicago, Chicago, Illinois.
Sonali M
SM
Smith
Division of Hematology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.
Jong Wook
JW
Lee
Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
Ernesto
E
Ayala
Division of Cell Therapy and Hematologica, Department of Medicine, Duke University Medical Center, Durham, North Carolina.
Nelson
N
Chao
Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
Parameswaran
P
Hari
The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland.
Javier
J
Bolaños-Meade
NIH-NCI Experimental Transplantation and Immunology Branch, Bethesda, Maryland.
Ronald
R
Gress
BMT Unit, Department of Hematology, Rigshospitalet, Copenhagen, Denmark.
Niels
N
Smedegaard Anderson
Division of Hematology/Oncology, Massachusetts General Hospital, Boston, Massachusetts.
Yi-Bin
YB
Chen
University of Iowa Hospitals & Clinics, Iowa City, Iowa.
Umar
U
Farooq
Hematological Malignancy/Stem Cell Transplant Program, David Geffen School of Medicine at UCLA, Los Angeles, California.
Gary
G
Schiller
Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Cancer Center, University of Maryland, Baltimore, Maryland.
Jean
J
Yared
Hematology Department, Institut Català d'Oncologia-Hospitalet, Barcelona, Spain.
Anna
A
Sureda
Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
Timothy S
TS
Fenske
Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin.
Horatiu
H
Olteanu
D000293:Adolescent; D000328:Adult; D000368:Aged; D016208:Databases, Factual; D018450:Disease Progression; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000401:mortality; D006801:Humans; D054066:Leukemia, Large Granular Lymphocytic / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012074:Remission Induction; D016019:Survival Analysis; D014184:Transplantation, Homologous; D055815:Young Adult
Aggressive natural killer cell leukemia; Allogeneic transplantation; Myeloablative; Reduced-intensity conditioning