Nakano Nobuaki, Utsunomiya Atae, Matsuo Keitaro, Yoshida Noriaki, Seto Masao, Ohshima Kouichi, Fujiwara Hiroshi, Fuji Shigeo, Takatsuka Yoshifusa, Ito Ayumu, Miyamoto Toshihiro, Suehiro Youko, Nakamae Hirohisa, Sawayama Yasushi, Yuasa Mitsuhiro, Miyazaki Yasuhiko, Ota Shuichi, Imada Kazunori, Fukuda Takahiro, Ichinohe Tatsuo, Atsuta Yoshiko, Kato Koji
Department of Hematology, Imamura General Hospital, Kagoshima, Japan.
ATL Working Group of Japan Society for Hematopoietic Cell Transplantation, Nagoya, Japan.
Blood Adv. 2021 Jan 26;5(2):475-486. doi: 10.1182/bloodadvances.2020003639.
Adult T-cell leukemia/lymphoma (ATL) cells frequently exhibit chromosomal abnormalities, including numerical aberrations and structural defects. However, no studies have examined the correlation between these abnormalities and survival in patients with ATL after allogeneic HSCT (allo-HSCT). In this study, 300 patients with ATL (median age, 55 years; range, 24-74) who were registered in a Japanese nationwide registry database were analyzed. The majority (n = 183) had acute ATL. Specimens for chromosomal analysis were collected from bone marrow (n = 166), lymph nodes (n = 86), peripheral blood (n = 41), and other locations (n = 7). In survival analyses, breakpoints at 2q (hazard ratio [HR], 1.63; 95% confidence interval [CI], 1.12-2.38; P = .012) and 5q (HR, 2.18; 95% CI, 1.25-3.80; P = .006) were significantly poor prognostic factors for overall survival (OS). In terms of ATL-related death, loss of chromosome 14 and breakpoints at 3p, 1q, 5q, and 6q were extracted as significantly poor prognostic factors. Moreover, complex karyotypes were associated with ATL-related death. This study of the survival impact of chromosomal abnormalities in patients with ATL after allo-HSCT demonstrated that several structural breakpoints were independent risk factors for OS and ATL-related death.
成人T细胞白血病/淋巴瘤（ATL）细胞经常出现染色体异常，包括数目畸变和结构缺陷。然而，尚无研究探讨这些异常与异基因造血干细胞移植（allo-HSCT）后ATL患者生存之间的相关性。在本研究中，分析了登记在日本全国登记数据库中的300例ATL患者（中位年龄55岁；范围24 - 74岁）。大多数患者（n = 183）为急性ATL。用于染色体分析的标本取自骨髓（n = 166）、淋巴结（n = 86）、外周血（n = 41）和其他部位（n = 7）。在生存分析中，2q处的断点（风险比[HR]，1.63；95%置信区间[CI]，1.12 - 2.38；P = 0.012）和5q处的断点（HR，2.18；95% CI，1.25 - 3.80；P = 0.006）是总生存（OS）的显著不良预后因素。就ATL相关死亡而言，14号染色体缺失以及3p、1q、5q和6q处的断点被确定为显著不良预后因素。此外，复杂核型与ATL相关死亡有关。这项关于allo-HSCT后ATL患者染色体异常对生存影响的研究表明，几个结构断点是OS和ATL相关死亡的独立危险因素。
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