Allogeneic stem-cell transplantation with reduced conditioning intensity as a novel immunotherapy and antiviral therapy for adult T-cell leukemia/lymphoma
Allogeneic stem-cell transplantation with reduced conditioning intensity as a novel immunotherapy and antiviral therapy for adult T-cell leukemia/lymphoma
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DOI：
10.1182/blood-2004-11-4193
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发表时间：
2005-05-15
期刊：
影响因子：
20.3
通讯作者：
Saburi, Y
中科院分区：
文献类型：
--
作者：
Okamura, J;Utsunomiya, A;Saburi, Y
16例年龄均大于50岁的成人T细胞白血病/淋巴瘤(ATL)患者接受了由氟达拉滨(180 mg/m(2))、白消安(8 mg/kg)和兔抗胸腺细胞球蛋白(5 mg/kg)组成的预适应方案后，进行了降低条件强度(RIST)的同种异基因干细胞移植。观察到的方案相关毒性和非血液学毒性均可接受。疾病复发是治疗失败的主要原因。三名复发的患者随后对快速停用免疫抑制剂有了反应，此后又获得了缓解。在RIST后，8名患者无法检测到人类T细胞白血病病毒1型(HTLV-1)前病毒载量。因此，RIST被认为是治疗ATL的一种可行的方法。我们的数据还表明可能存在移植物抗ATL效应；抗HTLV-1活性也被发现与这一过程有关。(C)2005年，由美国血液病学会提供。
Sixteen patients with adult T-cell leukemia/ lymphoma (ATL) who were all over 50 years of age underwent allogeneic stem cell transplantation with reduced-conditioning intensity (RIST) from HLA-matched sibling donors after a conditioning regimen consisting of fludarabine (180 mg/m(2)), busulfan (8 mg/ kg), and rabbit antithymocyte globulin (5 mg/kg). The observed regimen-related toxici- ties and nonhematologic toxicities were all found to be acceptable. Disease relapse was the main cause of treatment failure. Three patients who had a relapse subsequently responded to a rapid discontinuation of the immunosuppressive agent and thereafter achieved another remission. After RIST, the human T-cell leukemia virus type 1 (HTLV-1) proviral load became undetectable in 8 patients. RIST is thus considered to be a feasible treatment for ATL. Our data also suggest the presence of a possible graft-versus-ATL effect; an anti-HTLV-1 activity was also found to be associated with this procedure. (c) 2005 by The American Society of Hematology.