Abstract
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) has proven effective in adult T-cell leukemia/lymphoma (ATL) patients. To study the graft-versus-ATL (Gv-ATL) effects after allo-HSCT, we analyzed 21 ATL patients who had been treated at our hospital. Of these, 18 had acute-, 2 had lymphoma- and 1 had chronic-type ATL; at allo-HSCT, seven patients were in CR, one was in PR, five had stable disease (SD) and eight had progressive disease (PD). Disease state after allo-HSCT was CR in 14, PR in 3, SD in 1 and PD in 3 patients. Among 15 patients who survived longer than 100 days, ATL relapsed in 10 patients, skin relapsed in 9 patients and 5 had relapsed on the skin alone. After we discontinued immunosuppressant therapy in these 10 patients, 8 manifested GVHD; ATL was ameliorated to CR in 6 patients. Donor lymphocytes were infused into two patients who did not show GVHD; one obtained CR. In five patients with skin relapse alone, four patients achieved CR following the discontinuation of the immunosuppressants. Our results demonstrate that relapse of ATL after allo-HSCT tends to develop on skin, and Gv-ATL effects played a critical role in the outcome of allo-HSCT for ATL.
Similar content being viewed by others
References
Uchiyama T, Yodoi J, Sagawa K, Takatsuki K, Uchino H . Adult T-cell leukemia: clinical and hematologic features of 16 cases. Blood 1977; 50: 481–492.
Hinuma Y, Nagata K, Hanaoka M, Nakai M, Matsumoto T, Kinoshita K et al. Adult T-cell leukemia: antigen in an ATL cell line and detection of antibodies to the antigen in human sera. Proc Natl Acad Sci USA 1981; 78: 6476–6480.
Yoshida M, Miyoshi I, Hinuma Y . Isolation and characterization of retrovirus from cell lines of human adult T-cell leukemia and its implication in the disease. Proc Natl Acad Sci USA 1982; 79: 2031–2035.
Shimoyama M, Ota K, Kikuchi M, Yunoki K, Konda S, Takatsuki K et al. Chemotherapeutic results and prognostic factors of patients with advanced non-Hodgkin's lymphoma treated with VEPA or VEPA-M. J Clin Oncol 1998; 6: 128–141.
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: 375–382.
Tsukasaki K, Maeda T, Arimura K, Taguchi J, Fukushima T, Miyazaki Y et al. Poor outcome of autologous stem cell transplantation for adult T-cell leukemia/lymphoma: a case report and review of the literature. Bone Marrow Transplant 1999; 23: 87–89.
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 Transplant 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: 30430–30439.
Okamura J, Utsunomiya A, Tanosaki R, Uike N, Sonoda S, Kannagi M et al. Allogeneic stem-cell transplantation with reduced conditioning intensity as a novel immunotherapy and antiviral therapy for adult T-cell leukemia/lymphoma. Blood 2005; 105: 4143–4145.
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: 829–834.
Shimoyama M . Diagnostic criteria and classification of clinical subtypes of adult T-cell leukaemia-lymphoma. A report from the Lymphoma Study Group (1984–1987). Br J Haematol 1991; 79: 428–437.
Przepiorka D, Weisdorf D, Martin P, Klingemann HG, Beaty P, Hows J et al. 1994 Consensus conference on acute GVHD grading. Bone Marrow Transplant 1995; 15: 825–828.
Ishida T, Utsunomiya A, Iida S, Inagaki H, Takatsuka Y, Kusumoto S et al. Clinical significance of CCR4 expression in adult T-cell leukemia/lymphoma: its close association with skin involvement and unfavorable outcome. Clin Cancer Res 2003; 9: 3625–3634.
Ishida T, Iida S, Akatsuka Y, Ishii T, Miyazaki M, Komatsu H et al. The CC chemokine receptor 4 as a novel specific molecular target for immunotherapy in adult T-cell leukemia/lymphoma. Clin Cancer Res 2004; 10: 7529–7539.
Narducci MG, Scala E, Bresin A, Caprini E, Picchio MC, Remotti D et al. Skin homing of Sézary cells involves SDF-1-CXCR4 signaling and down-regulation of CD26/dipeptidylpeptidase IV. Blood 2006; 107: 1108–1115.
Goulmy E, Schipper R, Pool J, Blokland E, Falkenburg JH, Vossen J et al. Mismatches of minor histocompatibility antigens between HLA-identical donors and recipients and the development of graft-versus-host disease after bone marrow transplantation. N Engl J Med 1996; 334: 281–285.
Horowitz MM, Gale RP, Sondel PM, Goldman JM, Kersey J, Kolb HJ et al. Graft-versus-leukemia reactions after bone marrow transplantation. Blood 1990; 75: 555–562.
Koeppel MC, Stoppa AM, Resbeut M, Blaise D, Coignet M, Coulier L et al. Mycosis fungoides and allogenic bone marrow transplantation. Acta Derm Venereol 1994; 74: 331–332.
Guitart J, Wickless SC, Oyama Y, Kuzel TM, Rosen ST, Traynor A et al. Long-term remission after allogeneic hematopoietic stem cell transplantation for refractory cutaneous T-cell lymphoma. Arch Dermatol 2002; 138: 1359–1365.
Soligo D, Ibatici A, Berti E, Morandi P, Longhi E, Venegoni L et al. Treatment of advanced mycosis fungoides by allogeneic stem-cell transplantation with a nonmyeloablative regimen. Bone Marrow Transplant 2003; 31: 663–666.
Herbert KE, Spencer A, Grigg A, Ryan G, McCormack C, Prince HM . Graft-versus-lymphoma effect in refractory cutaneous T-cell lymphoma after reduced-intensity HLA-matched sibling allogeneic stem cell transplantation. Bone Marrow Transplant 2004; 34: 521–525.
Molina A, Nademanee A, Arber DA, Forman SJ . Remission of refractory Sézary syndrome after bone marrow transplantation from a matched unrelated donor. Biol Blood Marrow Transplant 1999; 5: 400–404.
Burt RK, Guitart J, Traynor A, Link C, Rosen S, Pandolfino T et al. Allogeneic hematopoietic stem cell transplantation for advanced mycosis fungoides: evidence of a graft-versus-tumor effect. Bone Marrow Transplant 2000; 25: 111–113.
Masood N, Russell KJ, Olerud JE, Sabath DE, Sale GE, Doney KC et al. Induction of complete remission of advanced stage mycosis fungoides by allogeneic hematopoietic stem cell transplantation. J Am Acad Dermatol 2002; 47: 140–145.
Fijnheer R, Sanders CJ, Canninga MR, de Weger RA, Verdonck LF . Complete remission of a radiochemotherapy-resistant cutaneous T-cell lymphoma with allogeneic non-myeloablative stem cell transplantation. Bone Marrow Transplant 2003; 32: 345–347.
Molina A, Zain J, Arber DA, Angelopolou M, O′Donnell M, Murata-Collins J et al. Durable clinical, cytogenetic, and molecular remissions after allogeneic hematopoietic cell transplantation for refractory Sézary syndrome and mycosis fungoides. J Clin Oncol 2005; 23: 6163–6171.
Ferrara JL, Deeg HJ, Division of Pediatric Oncology D-FCIBMA. Graft-versus-host disease. N Engl J Med 1991; 324: 667–674.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Yonekura, K., Utsunomiya, A., Takatsuka, Y. et al. Graft-versus-adult T-cell leukemia/lymphoma effect following allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 41, 1029–1035 (2008). https://doi.org/10.1038/bmt.2008.39
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/bmt.2008.39
- Springer Nature Limited
Keywords
This article is cited by
-
Mogamulizumab for post-transplant relapse of adult T-cell leukemia/lymphoma: a case study
International Journal of Hematology (2023)
-
Adult T-Cell Leukemia: a Comprehensive Overview on Current and Promising Treatment Modalities
Current Oncology Reports (2021)
-
GVHD-free, relapse-free survival provides novel clues for optimizing allogeneic-HSCT for adult T-cell leukemia/lymphoma
Bone Marrow Transplantation (2021)
-
A specific mode of microsatellite instability is a crucial biomarker in adult T-cell leukaemia/lymphoma patients
Journal of Cancer Research and Clinical Oncology (2017)
-
Striving to cure adult T-cell leukaemia/lymphoma: a role for allogeneic stem cell transplant?
Bone Marrow Transplantation (2016)