Newly identified poor prognostic factors for adult T-cell leukemia-lymphoma treated with allogeneic hematopoietic stem cell transplantation

Leuk Lymphoma. 2017 Jan;58(1):37-44. doi: 10.1080/10428194.2016.1187270. Epub 2016 Sep 22.

Abstract

To explore pre-transplantation prognostic factors for adult T-cell leukemia-lymphoma (ATL), we retrospectively analyzed allogeneic hematopoietic stem cell transplantation (allo-HSCT) in 70 patients at our institute (63 acute type and seven lymphoma type patients). Forty-five patients died after HSCT and the three-year overall survival (OS) rate was 35.2%. By univariate analysis, the adverse prognostic factors for OS were performance status ≥2, hematopoietic cell transplantation-specific comorbidity index (HCT-CI) score ≥3, European Group for Blood and Marrow Transplantation (EBMT) risk score ≥5, HSCT from an HLA-mismatched donor, serum soluble interleukin-2 receptor (sIL-2R) level ≥10,000 U/mL, lymphocyte count ≥4000/μL, and hemoglobin <9 g/dL at the time of HSCT. EBMT risk score and sIL-2R were identified as significant adverse prognostic factors using multivariate analysis. This analysis clearly demonstrates for the first time that HCT-CI and EBMT risk scores are reliable prognostic factors for ATL patients receiving allo-HSCT.

Keywords: Adult T-cell leukemia-lymphoma; European Group for Blood and Marrow Transplantation risk score; allogeneic hematopoietic stem cell transplantation; hematopoietic cell transplantation-specific comorbidity index; prognostic factor.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Combined Modality Therapy
  • Female
  • Graft vs Host Disease / diagnosis
  • Graft vs Host Disease / etiology
  • Graft vs Host Disease / prevention & control
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Leukemia-Lymphoma, Adult T-Cell / epidemiology
  • Leukemia-Lymphoma, Adult T-Cell / mortality*
  • Leukemia-Lymphoma, Adult T-Cell / therapy*
  • Male
  • Middle Aged
  • Prognosis
  • Proportional Hazards Models
  • Remission Induction
  • Transplantation, Homologous
  • Treatment Outcome
  • Young Adult