Abdul-Hamid Bazarbachi, Daniel Reef, Hiba Narvel, Riya Patel, Rama Al Hamed, Sindhu Vikash, Karun Neupane, Eleftheria Atalla, Astha Thakkar, Shafia Rahman, Urvi Shah, Diego Adrianzen-Herrera, Ryann Quinn, Sumaira Zareef, Emma Rabinovich, Alyssa De Castro, Felisha Joseph, Kailyn Gillick, Jennat Mustafa, Fariha Khatun, Amanda Lombardo, Latoya Townsend-Nugent, Michelly Abreu, Nicole Chambers, Richard Elkind, Yang Shi, Yanhua Wang, Olga Derman, Kira Gritsman, Ulrich Steidl, Mendel Goldfinger, Noah Kornblum, Aditi Shastri, Ioannis Mantzaris, Liza Bachier-Rodriguez, Nishi Shah, Dennis Cooper, Amit Verma, Bihui Hilda Ye, Murali Janakiram, Roberto Alejandro Sica
{"title":"干细胞移植治疗htlv -1相关北美成人t细胞白血病/淋巴瘤的疗效","authors":"Abdul-Hamid Bazarbachi, Daniel Reef, Hiba Narvel, Riya Patel, Rama Al Hamed, Sindhu Vikash, Karun Neupane, Eleftheria Atalla, Astha Thakkar, Shafia Rahman, Urvi Shah, Diego Adrianzen-Herrera, Ryann Quinn, Sumaira Zareef, Emma Rabinovich, Alyssa De Castro, Felisha Joseph, Kailyn Gillick, Jennat Mustafa, Fariha Khatun, Amanda Lombardo, Latoya Townsend-Nugent, Michelly Abreu, Nicole Chambers, Richard Elkind, Yang Shi, Yanhua Wang, Olga Derman, Kira Gritsman, Ulrich Steidl, Mendel Goldfinger, Noah Kornblum, Aditi Shastri, Ioannis Mantzaris, Liza Bachier-Rodriguez, Nishi Shah, Dennis Cooper, Amit Verma, Bihui Hilda Ye, Murali Janakiram, Roberto Alejandro Sica","doi":"10.1007/s44228-023-00032-y","DOIUrl":null,"url":null,"abstract":"<p><p>Adult T-cell leukemia/lymphoma (ATLL) remains challenging to treat and has dismal outcome. Allogeneic stem-cell transplantation (allo-SCT) has promising results, but data remain scarce. In this single-center retrospective analysis of 100 patients with ATLL from north America (67 acute, 22 lymphomatous), 17 underwent allo-SCT and 5 autologous SCT (ASCT), with a median follow-up of 65 months. Post-transplant 3-years relapse incidence (RI) and non-relapse mortality (NRM) were 51% and 37%, respectively, and 3-year progression-free survival (PFS) and overall survival (OS) were 31% and 35%, respectively. ASCT 1-year RI was 80% compared to 30% in allo-SCT (p = 0.03). After adjusting for immortal-time bias, allo-SCT had significantly improved OS (HR = 0.4, p = 0.01). In exploratory multivariate analysis, patients achieving first complete response and Karnofsky score ≥ 90 had significantly better outcomes, as did Black patients, compared to Hispanics, who had worse outcome. In transplanted patients, 14 died within 2 years, 4 of which ASCT recipients. Our data are the largest ATLL transplant cohort presented to date outside of Japan and Europe. We show that allo-SCT, but not ASCT, is a valid option in select ATLL patients, and can induce long term survival, with 40% of patients alive after more than 5 years.</p>","PeriodicalId":10368,"journal":{"name":"Clinical Hematology International","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10241770/pdf/","citationCount":"1","resultStr":"{\"title\":\"Outcome of Stem Cell Transplantation in HTLV-1-Associated North American Adult T-Cell Leukemia/Lymphoma.\",\"authors\":\"Abdul-Hamid Bazarbachi, Daniel Reef, Hiba Narvel, Riya Patel, Rama Al Hamed, Sindhu Vikash, Karun Neupane, Eleftheria Atalla, Astha Thakkar, Shafia Rahman, Urvi Shah, Diego Adrianzen-Herrera, Ryann Quinn, Sumaira Zareef, Emma Rabinovich, Alyssa De Castro, Felisha Joseph, Kailyn Gillick, Jennat Mustafa, Fariha Khatun, Amanda Lombardo, Latoya Townsend-Nugent, Michelly Abreu, Nicole Chambers, Richard Elkind, Yang Shi, Yanhua Wang, Olga Derman, Kira Gritsman, Ulrich Steidl, Mendel Goldfinger, Noah Kornblum, Aditi Shastri, Ioannis Mantzaris, Liza Bachier-Rodriguez, Nishi Shah, Dennis Cooper, Amit Verma, Bihui Hilda Ye, Murali Janakiram, Roberto Alejandro Sica\",\"doi\":\"10.1007/s44228-023-00032-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Adult T-cell leukemia/lymphoma (ATLL) remains challenging to treat and has dismal outcome. Allogeneic stem-cell transplantation (allo-SCT) has promising results, but data remain scarce. In this single-center retrospective analysis of 100 patients with ATLL from north America (67 acute, 22 lymphomatous), 17 underwent allo-SCT and 5 autologous SCT (ASCT), with a median follow-up of 65 months. Post-transplant 3-years relapse incidence (RI) and non-relapse mortality (NRM) were 51% and 37%, respectively, and 3-year progression-free survival (PFS) and overall survival (OS) were 31% and 35%, respectively. ASCT 1-year RI was 80% compared to 30% in allo-SCT (p = 0.03). After adjusting for immortal-time bias, allo-SCT had significantly improved OS (HR = 0.4, p = 0.01). In exploratory multivariate analysis, patients achieving first complete response and Karnofsky score ≥ 90 had significantly better outcomes, as did Black patients, compared to Hispanics, who had worse outcome. In transplanted patients, 14 died within 2 years, 4 of which ASCT recipients. Our data are the largest ATLL transplant cohort presented to date outside of Japan and Europe. We show that allo-SCT, but not ASCT, is a valid option in select ATLL patients, and can induce long term survival, with 40% of patients alive after more than 5 years.</p>\",\"PeriodicalId\":10368,\"journal\":{\"name\":\"Clinical Hematology International\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10241770/pdf/\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Hematology International\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s44228-023-00032-y\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Hematology International","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s44228-023-00032-y","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Outcome of Stem Cell Transplantation in HTLV-1-Associated North American Adult T-Cell Leukemia/Lymphoma.
Adult T-cell leukemia/lymphoma (ATLL) remains challenging to treat and has dismal outcome. Allogeneic stem-cell transplantation (allo-SCT) has promising results, but data remain scarce. In this single-center retrospective analysis of 100 patients with ATLL from north America (67 acute, 22 lymphomatous), 17 underwent allo-SCT and 5 autologous SCT (ASCT), with a median follow-up of 65 months. Post-transplant 3-years relapse incidence (RI) and non-relapse mortality (NRM) were 51% and 37%, respectively, and 3-year progression-free survival (PFS) and overall survival (OS) were 31% and 35%, respectively. ASCT 1-year RI was 80% compared to 30% in allo-SCT (p = 0.03). After adjusting for immortal-time bias, allo-SCT had significantly improved OS (HR = 0.4, p = 0.01). In exploratory multivariate analysis, patients achieving first complete response and Karnofsky score ≥ 90 had significantly better outcomes, as did Black patients, compared to Hispanics, who had worse outcome. In transplanted patients, 14 died within 2 years, 4 of which ASCT recipients. Our data are the largest ATLL transplant cohort presented to date outside of Japan and Europe. We show that allo-SCT, but not ASCT, is a valid option in select ATLL patients, and can induce long term survival, with 40% of patients alive after more than 5 years.
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