Abstract
It has been reported that cord blood transplantation (CBT) for patients with aggressive adult T-cell leukemia/lymphoma (ATL) results in poorer outcomes than transplantation using other stem cell sources. To identify a subset of ATL in which CBT is feasible, we retrospectively analyzed 27 patients treated with CBT at three institutions in Nagasaki Prefecture, Japan. The estimated overall survival (OS) rate at 3 years was 27.4 %. Of 16 patients who received CBT during remission (complete, CR, or partial, PR), the OS rate at 3 years was 50 %, while during refractory periods (non-CR or non-PR), the OS rate was 9.1 %. Reduced intensity conditioning (RIC) was given to 18 patients, and myeloablative conditioning (MAC) was used in nine, with 3-year OS of 50.0 and 0 %, respectively. Of the 19 deaths, nine were due to progressive disease, eight (five MAC and three RIC) to infection, and two to multiple organ failure. These results suggest that CBT provides similar results with those in other transplantation procedures for selected ATL patients, such as those in CR or PR. Further studies are needed to evaluate the use of CBT in aggressive ATL.
Similar content being viewed by others
References
Utsunomiya A, Miyazaki Y, Takatsuka Y, Hanada S, Uozumi K, Yashiki S, et al. Improved outcome of adult T-cell leukemia/lymphoma with allogeneic hematopoietic stem cell transplantation. Bone Marrow Transpl. 2001;27:15–20.
Kami M, Hamaki T, Miyakoshi S, Murashige N, Kanda Y, Tanosaki R, et al. Allogeneic haematopoietic stem cell transplantation for the treatment of adult T-cell leukaemia/lymphoma. Br J Haematol. 2003;120:304–9.
Fukushima T, Miyazaki Y, Honda S, Kawano F, Moriuchi Y, Masuda M, et al. Allogeneic hematopoietic stem cell transplantation provides sustained long-term survival for patients with adult T-cell leukemia/lymphoma. Leukemia. 2005;19:829–34.
Kato K, Kanda Y, Eto T, Muta T, Gondo H, Taniguchi S, et al. Allogeneic bone marrow transplantation from unrelated human T-cell leukemia virus-I-negative donors for adult T-cell leukemia/lymphoma: retrospective analysis of data from the Japan Marrow Donor Program. Biol Blood Marrow Transpl. 2007;13:90–9.
Okamura J, Utsunomiya A, Tanosaki R, Uike N, Sonoda S, Kannagi M, et al. Allogeneic stem-cell transplantation with reduced conditioning intensity as novel immunotherapy and antiviral therapy for adult T-cell leukemia/lymphoma. Blood. 2005;105:4143–5.
Tanosaki R, Uike N, Utsunomiya A, Saburi Y, Masuda M, Tomonaga M, et al. Allogeneic hematopoietic stem cell transplantation using reduced-intensity conditioning for adult T cell leukemia/lymphoma: impact of antithymocyte globulin on clinical outcome. Biol Blood Marrow Transpl. 2008;14:702–8.
Choi I, Tanosaki R, Uike N, Utsunomiya A, Tomonaga M, Harada M, et al. Long-term outcomes after hematopoietic SCT for adult T-cell leukemia/lymphoma: results of prospective trials. Bone Marrow Transpl. 2011;46:116–8.
Hishizawa M, Kanda J, Utsunomiya A, Taniguchi S, Eto T, Moriuchi Y, et al. Transplantation of allogeneic hematopoietic stem cells for adult T-cell leukemia: a nationwide retrospective study. Blood. 2010;116:1369–76.
Kanda J, Hishizawa M, Utsunomiya A, Taniguchi S, Eto T, Moriuchi Y, et al. Impact of graft-versus-host disease on outcome after allogeneic hematopoietic cell transplantation for adult T-cell leukemia: a retrospective cohort study. Blood. 2012;119:2141–8.
Ishida T, Hishizawa M, Kato K, Tanosaki R, Fukuda T, Taniguchi S, et al. Allogeneic hematopoietic stem cell transplantation for adult T-cell leukemia–lymphoma with special emphasis on preconditioning regimen: a nationwide retrospective study. Blood. 2012;120:1734–41.
Yamada Y, Tomonaga M, Fukuda H, Hanada S, Utsunomiya A, Tara M, et al. A new G-CSF-supported combination chemotherapy, LSG15, for adult T-cell leukaemia–lymphoma: Japan Clinical Oncology Group Study 9303. Br J Haematol. 2001;113:375–82.
Tsukasaki K, Utsunomiya A, Fukuda H, Shibata T, Fukushima T, Takatsuka Y, et al. VCAP-AMP-VECP compared with biweekly CHOP for adult T-cell leukemia–lymphoma: Japan Clinical Oncology Group Study JCOG9801. J Clin Oncol. 2007;25:5458–64.
Rocha V, Labopin M, Sanz G, Arcese W, Schwerdtfeger R, Bosi A, et al. Transplants of umbilical-cord blood or bone marrow from unrelated donors in adults with acute leukemia. N Engl J Med. 2004;351:2276–85.
Laughlin M, Espen M, Rubinstein P, Wagner JE, Zhang MJ, Champlin RE, et al. Outcome after transplantation of cord blood or bone marrow from unrelated donors in adults with leukemia. N Engl J Med. 2004;351:2265–75.
Uchiyama T, Human T. T cell leukemia virus type I (HTLV-1) and human diseases. Annu Rev Immunol. 1997;15:15–37.
Vendonck K, Gonzalez E, Van Dooren S, Vandemme AM, Vanharn G, Gotuzzo E. Human T-lymphotropic virus 1: recent knowledge about an ancient infection. Lancet Infect Dis. 2007;7:266–81.
Takahashi S, Iseki T, Ooi J, Tomonari A, Takasugi K, Shimohakamada Y, et al. Single-institute comparative analysis of unrelated bone marrow transplantation and cord blood transplantation for adult patients with hematologic malignancies. Blood. 2004;104:3813–20.
Takahashi S, Ooi J, Tomonari A, Konuma T, Tsukada N, Oiwa-Monna M, et al. Comparative single-institute analysis of cord blood transplantation from unrelated donors with bone marrow or peripheral blood stem-cell transplants from related donors in adult patients with hematologic malignancies after myeloablative conditioning regimen. Blood. 2007;109:1322–30.
Fukushima T, Horio Y, Matsuo E, Imanishi D, Yamasaki R, Tsushima H, et al. Successful cord blood transplantation for mycosis fungoides. Int J Hematol. 2008;88:596–8.
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Fukushima, T., Itonaga, H., Moriuchi, Y. et al. Feasibility of cord blood transplantation in chemosensitive adult T-cell leukemia/lymphoma: a retrospective analysis of the Nagasaki Transplantation Network. Int J Hematol 97, 485–490 (2013). https://doi.org/10.1007/s12185-013-1307-y
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12185-013-1307-y