High Level of Serum Soluble Interleukin-2 Receptor at Transplantation Predicts Poor Outcome of Allogeneic Stem Cell Transplantation for Adult T Cell Leukemia.
High Level of Serum Soluble Interleukin-2 Receptor at Transplantation Predicts Poor Outcome of Allogeneic Stem Cell Transplantation for Adult T Cell Leukemia.
复制标题
移植时血清可溶性白介素 2 受体水平高预示着成人 T 细胞白血病同种异体干细胞移植的不良结果。
DOI：
10.1016/j.bbmt.2014.02.014
复制
发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Teshima T.
中科院分区：
文献类型：
--
作者：
Shigematsu A;Kobayashi N;Yasui H;Shindo M;Kakinoki Y;Koda K;Iyama S;Kuroda H;Tsutsumi Y;Imamura M;Teshima T.
成人T细胞白血病/淋巴瘤(ATL)的预后很差，只有异基因造血干细胞移植(allo-SCT)被认为是治疗ATL的有效方法。在这项研究中，我们回顾分析了在日本最北端的岛屿北海道接受allo-SCT治疗ATL的患者的数据，以确定预后因素。56例患者接受了allo-SCT，平均年龄57岁。急性型28例(50.0%)，淋巴瘤型22例(46.4%)。23例(41.1%)患者在完全缓解(CR)时接受了allo-SCT，其余患者在非CR时接受了allo-SCT。17例(30.4%)患者接受清髓预适应，其余患者接受低强度预适应。中位随访期48个月(17~134个月)，1年和5年总生存率分别为55.4%和46.1%。干细胞移植(SCT)后22个月，存活曲线达到平台期。男性、SCT时血清可溶性白介素2受体(sIL-2R)水平高、SCT时无CR是OS的重要危险因素。单因素分析显示，SCT时高水平的sIL-2R是SCT时非CR患者OS不良的危险因素(P=0.02)，经性别调整后仍显著(危险比2.73[95%可信区间1.07至7.90])。SCT时高水平的sIL-2R也被确定为疾病进展的危险因素(P=0.02)。这项区域范围的研究显示，对于ATL患者，异基因SCT后的存活率有令人鼓舞的结果，并首次证明SCT中高水平的sIL-2R预示着SCT结果更差。
The prognosis for adult T cell leukemia/lymphoma (ATL) is very poor, and only allogeneic hematopoietic stem cell transplantation (allo-SCT) has been considered to be a curative treatment for ATL. In this study, we retrospectively analyzed data for patients who had received allo-SCT for ATL in Hokkaido, the northernmost island of Japan, to determine prognostic factors. Fifty-six patients with a median age of 57 years received allo-SCT. Twenty-eight (50.0%) patients had acute type and 22 (46.4%) had lymphoma type. Twenty-three (41.1%) patients received allo-SCT in complete remission (CR), whereas the others were in non-CR. Seventeen (30.4%) patients received myeloablative conditioning and the others received reduced-intensity conditioning. With a median follow-up period of 48 months (range, 17 to 134 months), 1-year overall survival (OS) and 5-year OS rates were 55.4% and 46.1%, respectively. The survival curve reached a plateau at 22 months after stem cell transplantation (SCT). Male sex, high level of serum soluble interleukin-2 receptor (sIL-2R) at SCT, and non-CR at SCT were determined to be significant risk factors for OS. A high level of sIL-2R at SCT was a risk factor for poor OS in patients with non-CR at SCT by univariate analysis (P= .02), and it remained significant after adjustment by sex (hazard ratio, 2.73 [95% confidence interval, 1.07 to 7.90]). A high level of sIL-2R at SCT was also determined to be a risk factor for disease progression (P= .02). This region-wide study showed encouraging results for survival after allo-SCT for ATL and demonstrated for the first time that a high level of sIL-2R at SCT predicts worse SCT outcome.