Fuji S, Fujiwara H, Nakano N, Wake A, Inoue Y, Fukuda T, Hidaka M, Moriuchi Y, Miyamoto T, Uike N, Taguchi J, Eto T, Tomoyose T, Kondo T, Yamanoha A, Ichinohe T, Atsuta Y, Utsunomiya A
Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan.
First Department of Internal Medicine, Ehime University Hospital, Ehime, Japan.
Bone Marrow Transplant. 2016 Feb;51(2):205-11. doi: 10.1038/bmt.2015.265. Epub 2015 Nov 2.
Allogeneic hematopoietic SCT (allo-HSCT) is a curative treatment for aggressive adult T-cell leukemia/lymphoma (ATLL). Considering the dismal prognosis associated with conventional chemotherapies, early application of allo-HSCT might be beneficial for patients with ATLL. However, no previous study has addressed the optimal timing of allo-HSCT from related donors. Hence, to evaluate the impact of timing of allo-HSCT for patients with ATLL, we retrospectively analyzed data from patients with ATLL who received an allo-HSCT from a related donor. The median age was 52 years. Patients were grouped according to the interval from diagnosis to allo-HSCT: early transplant group, <100 days, n=72; late transplant group, ⩾100 days, n=428. The corresponding constituents of disease status were not statistically different between the two groups (P=0.11). The probability of OS in the early transplant group was significantly higher than that in the late transplant group (4-year OS, 49.3% vs 31.2%). Multivariate analysis revealed that late allo-HSCT was an unfavorable prognostic factor for OS (hazard ratio, 1.46; 95% confidence interval (CI), 1.01-2.11; P=0.04). Despite the limitations of a retrospective study, it might be acceptable to consider early application of allo-HSCT for ATLL.
异基因造血干细胞移植（allo-HSCT）是侵袭性成人T细胞白血病/淋巴瘤（ATLL）的一种治愈性治疗方法。鉴于传统化疗的预后不佳，早期应用allo-HSCT可能对ATLL患者有益。然而，此前尚无研究探讨来自相关供者的allo-HSCT的最佳时机。因此，为了评估allo-HSCT时机对ATLL患者的影响，我们回顾性分析了接受相关供者allo-HSCT的ATLL患者的数据。中位年龄为52岁。患者根据从诊断到allo-HSCT的间隔时间分组：早期移植组，<100天，n = 72；晚期移植组，⩾100天，n = 428。两组疾病状态的相应构成在统计学上无差异（P = 0.11）。早期移植组的总生存概率显著高于晚期移植组（4年总生存率，49.3%对31.2%）。多因素分析显示，晚期allo-HSCT是总生存的不良预后因素（风险比，1.46；95%置信区间（CI），1.01 - 2.11；P = 0.04）。尽管回顾性研究存在局限性，但考虑对ATLL早期应用allo-HSCT可能是可以接受的。
