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

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
• allogeneic hematopoietic stem cell transplantation
• European Group for Blood and Marrow Transplantation risk score
• hematopoietic cell transplantation-specific comorbidity index
• prognostic factor

Acknowledgements

We thank all the patients, their families, nurses, clinical research coordinators, and medical experts who were involved in this study for their excellent cooperation. The secretarial assistance of Ms. Anri Takenaka is very much appreciated. This study was supported in part by the Practical Research for Innovative Cancer Control from Japan Agency for Medical Research and Development, AMED (MS and AU).

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article at http://dx.doi.org/10.1080/10428194.2016.1187270.