The outcome and characteristics of patients with relapsed adult T cell leukemia/lymphoma after allogeneic hematopoietic stem cell transplantation

Hematological Oncology
Koji KatoATL Working Group of the Japan Society for Hematopoietic Cell Transplantation

Abstract

Treatment options for patients with adult T cell leukemia/lymphoma (ATLL) who have relapsed disease after allogeneic hematopoietic stem cell transplantation (allo-HSCT) are limited. To clarify which patients with ATLL are likely to benefit from these treatment options and to define patient populations for novel treatments, we performed a nationwide retrospective analysis of 252 Japanese patients who had relapsed ATLL after allo-HSCT. Some long-term survivors remained after tapering and withdrawal of immunosuppressive agents. Thirty-six patients who received donor lymphocyte infusion had a better overall survival (OS) in comparison to those who did not [hazard ratio (HR), 0.63; 95% confidence interval (CI), 0.43-0.93; P = .02], suggesting the efficacy of a graft-versus-ATLL (GvATLL) effect even after relapse. Multivariate analysis demonstrated that skin lesions at initial relapse of ATLL were independently associated with higher OS (HR, 0.41; 95% CI, 0.22-0.74; P = .003), indicating that the skin is a susceptible target organ of GvATLL. This study suggested that enhancement of a GvATLL effect is a potential therapeutic option for relapsed disease after allo-HSCT. Further investigations of incorporation of immune-based approaches...Continue Reading

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Citations

Jul 9, 2020·Frontiers in Microbiology·Kunihiro TsukasakiAli Bazarbachi
Jul 19, 2021·Transplantation and Cellular Therapy·Takashi TanakaTakahiro Fukuda
Sep 1, 2021·Bone Marrow Transplantation·Yoshitaka InoueUNKNOWN ATL Working Group of the Japan Society for Hematopoietic Cell Transplantation
Dec 5, 2021·European Journal of Haematology·Kisato NosakaTakeshi Takahashi

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