A retrospective analysis of haplo-identical HLA-mismatch hematopoietic transplantation without posttransplantation cyclophosphamide for GVHD prophylaxis in patients with adult T-cell leukemia-lymphoma.
A retrospective analysis of haplo-identical HLA-mismatch hematopoietic transplantation without posttransplantation cyclophosphamide for GVHD prophylaxis in patients with adult T-cell leukemia-lymphoma.
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不使用移植后环磷酰胺的单倍体 HLA 不匹配造血移植对成人 T 细胞白血病-淋巴瘤患者 GVHD 预防的回顾性分析。
DOI：
10.1038/s41409-018-0400-5
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Kato K.
中科院分区：
文献类型：
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作者：
Yoshimitsu M;Utsunomiya A;Fuji S;Fujiwara H;Fukuda T;Ogawa H;Takatsuka Y;Ishitsuka K;Yokota A;Okumura H;Ishii K;Nishikawa A;Eto T;Yonezawa A;Miyashita K;Tsukada J;Tanaka J;Atsuta Y;Kato K.
目前，异基因造血干细胞移植(allo-HCT)是治疗成人T细胞白血病-淋巴瘤(ATL)的唯一有效方法。当与移植后环磷酰胺(PTCY)联合使用预防移植物抗宿主病时，来自一个HLA半相合供者的allo-HCT对ATL以外的许多疾病都有很好的疗效。然而，需要与其他供者来源，特别是脐带血和传统的HLA半相合供者进行适当的比较，以验证该方法的安全性和有效性。在这项研究中，我们回顾评估了1985至2015年间在日本造血细胞移植协会Trump数据库注册的ATL患者中没有PTCY的allo-HCT的结果。在此期间，46名患者接受了无PTCY的allo-HCT，并对幸存者进行了中位时间为2316.5天的随访。虽然整个队列的估计1年和5年总存活率分别为34.5%和17.7%，但累积的1年和5年非ATL死亡率分别为41.3%和55.8%，是很高的。我们的研究结果将作为一个平台，讨论在未来ATL患者的临床试验中单核细胞移植的安全性和有效性。
Currently, allogeneic hematopoietic stem cell transplantation (allo-HCT) is the only available curative modality for patients with adult T-cell leukemia–lymphoma (ATL). When used in conjunction with posttransplantation cyclophosphamide (PTCY) for graft-versus-host disease prophylaxis, allo-HCT from an HLA haplo-identical donor yields promising outcomes for many diseases other than ATL. However, appropriate comparisons with other donor sources, especially cord blood and conventional HLA haplo-identical donors, are needed to validate the safety and efficacy of this modality. In this study, we retrospectively evaluated the outcome of allo-HCT without PTCY in patients with ATL registered in the Japan Society for Hematopoietic Cell Transplantation TRUMP database between 1985 and 2015. During that period, 46 patients received allo-HCT without PTCY and survivors were followed for a median of 2316.5 days (range: 220–3884 days). Although the estimated 1- and 5-year overall survival rates of the entire cohort were 34.5% and 17.7%, respectively, the cumulative 1- and 5-year non-ATL mortality rates of 41.3% and 55.8%, respectively, were high. The results of our study will serve as a platform for discussions of the safety and efficacy of haplo-HCT for future clinical trials in patients with ATL.