TY - JOUR
T1 - Outcomes of Allogeneic Hematopoietic Stem Cell Transplantation for ATL with HTLV-1 Antibody-Positive Donors
T2 - Allo-HCT for ATL from HTLV-1 Antibody-Positive Donors
AU - ATL Working Group of the Japan Society for Hematopoietic Cell Transplantation
AU - Yoshimitsu, Makoto
AU - Fuji, Shigeo
AU - Utsunomiya, Atae
AU - Nakano, Nobuaki
AU - Ito, Ayumu
AU - Ito, Yoshikiyo
AU - Miyamoto, Toshihiro
AU - Suehiro, Youko
AU - Kawakita, Toshiro
AU - Moriuchi, Yukiyoshi
AU - Nakamae, Hirohisa
AU - Kanda, Yoshinobu
AU - Ichinohe, Tatsuo
AU - Fukuda, Takahiro
AU - Atsuta, Yoshiko
AU - Kato, Koji
N1 - Funding Information:
The authors thank all the physicians and data managers at the participating institutions who contributed valuable data on transplantation for ATL to the JSHCT. Additionally, the authors thank all members of the data management committees of the JSHCT. Financial disclosure: This work was supported in part by the Practical Research Project for Allergic Diseases and Immunology (Research Technology of Medical Transplantation) from the Japan Agency for Medical Research and Development (AMED; grant 19ek0510023h0002 ). Conflict of interest statement: There are no conflicts of interest to report. Authorship statement: M.Y., S.F., A.U., N.N., and K.K. designed the research, organized the project, and wrote the manuscript; M.Y. performed the statistical analyses; and A.I., Y.I., T.M., Y.S., T.K., Y.M., H.N., Y. K., T.I., T.F., and Y.A. gathered the data. All authors contributed to the final version of the manuscript and approved it for submission for publication.
Funding Information:
The authors thank all the physicians and data managers at the participating institutions who contributed valuable data on transplantation for ATL to the JSHCT. Additionally, the authors thank all members of the data management committees of the JSHCT. Financial disclosure: This work was supported in part by the Practical Research Project for Allergic Diseases and Immunology (Research Technology of Medical Transplantation) from the Japan Agency for Medical Research and Development (AMED; grant 19ek0510023h0002). Conflict of interest statement: There are no conflicts of interest to report. Authorship statement: M.Y. S.F. A.U. N.N. and K.K. designed the research, organized the project, and wrote the manuscript; M.Y. performed the statistical analyses; and A.I. Y.I. T.M. Y.S. T.K. Y.M. H.N. Y. K. T.I. T.F. and Y.A. gathered the data. All authors contributed to the final version of the manuscript and approved it for submission for publication. Financial disclosure: See Acknowledgments on page 622.
Publisher Copyright:
© 2019 American Society for Transplantation and Cellular Therapy
PY - 2020/4
Y1 - 2020/4
N2 - Allogeneic hematopoietic stem cell transplantation (allo-HCT) is the only available curative treatment option for patients with aggressive adult T cell leukemia-lymphoma (ATL). Donor human T cell leukemia virus (HTLV) 1 seropositivity is a critical concern when choosing relative donors, as they are not usually recommended due solely to the occurrence of donor-derived ATL. A previous report suggested that allo-HCT with an HTLV-1-seropositive donor increased ATL-related mortality. We updated the risk assessment for choosing an HTLV-1-seropositive allo-HCT donor for ATL. Our current registry data, which include larger numbers of HTLV-1-seropositive donors and longer observation periods, revealed no significant difference in overall survival (hazard ratio [HR], 0.93; 95% confidence interval [CI], 0.70-1.24; P = .61) or cumulative incidence of either ATL-related (HR, 0.96; 95% CI, 0.64 to 1.45; P = .80) or non-ATL-related mortality (HR, 0.91; 95% CI, 0.61 to 1.37; P = .66). Similarly, when considering only patients with ATL in complete remission, there was no significant difference in overall survival (HR, 1.02; 95% CI, 0.70 to 1.49; P = .91) or cumulative incidence of either ATL-related (HR, 1.20; 95% CI, 0.66 to 2.20; P=0.54) or non-ATL-related mortality (HR, 0.86; 95% CI, 0.52-1.42; P = .66). These data indicate that selecting HTLV-1-seropositive donors might not be contraindicated for patients with ATL receiving allo-HCT if alternative donors are unavailable. Further risk assessment remains to be performed.
AB - Allogeneic hematopoietic stem cell transplantation (allo-HCT) is the only available curative treatment option for patients with aggressive adult T cell leukemia-lymphoma (ATL). Donor human T cell leukemia virus (HTLV) 1 seropositivity is a critical concern when choosing relative donors, as they are not usually recommended due solely to the occurrence of donor-derived ATL. A previous report suggested that allo-HCT with an HTLV-1-seropositive donor increased ATL-related mortality. We updated the risk assessment for choosing an HTLV-1-seropositive allo-HCT donor for ATL. Our current registry data, which include larger numbers of HTLV-1-seropositive donors and longer observation periods, revealed no significant difference in overall survival (hazard ratio [HR], 0.93; 95% confidence interval [CI], 0.70-1.24; P = .61) or cumulative incidence of either ATL-related (HR, 0.96; 95% CI, 0.64 to 1.45; P = .80) or non-ATL-related mortality (HR, 0.91; 95% CI, 0.61 to 1.37; P = .66). Similarly, when considering only patients with ATL in complete remission, there was no significant difference in overall survival (HR, 1.02; 95% CI, 0.70 to 1.49; P = .91) or cumulative incidence of either ATL-related (HR, 1.20; 95% CI, 0.66 to 2.20; P=0.54) or non-ATL-related mortality (HR, 0.86; 95% CI, 0.52-1.42; P = .66). These data indicate that selecting HTLV-1-seropositive donors might not be contraindicated for patients with ATL receiving allo-HCT if alternative donors are unavailable. Further risk assessment remains to be performed.
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U2 - 10.1016/j.bbmt.2019.12.004
DO - 10.1016/j.bbmt.2019.12.004
M3 - Article
C2 - 31821886
AN - SCOPUS:85077702893
SN - 1083-8791
VL - 26
SP - 718
EP - 722
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 4
ER -
