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Outcomes of Allogeneic Hematopoietic Stem Cell Transplantation for ATL with HTLV-1 Antibody-Positive Donors
- Source :
- Biology of Blood and Marrow Transplantation. 26:718-722
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- 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.
- Subjects :
- Adult
Oncology
medicine.medical_specialty
viruses
medicine.medical_treatment
T cell
Hematopoietic stem cell transplantation
Adult T-cell leukemia/lymphoma
03 medical and health sciences
0302 clinical medicine
immune system diseases
hemic and lymphatic diseases
Internal medicine
Humans
Leukemia-Lymphoma, Adult T-Cell
Medicine
Cumulative incidence
Human T-lymphotropic virus 1
Transplantation
business.industry
Remission Induction
Hazard ratio
Hematopoietic Stem Cell Transplantation
Hematology
medicine.disease
Tissue Donors
Confidence interval
HTLV-1 Antibody
medicine.anatomical_structure
030220 oncology & carcinogenesis
business
Risk assessment
030215 immunology
Subjects
Details
- ISSN :
- 10838791
- Volume :
- 26
- Database :
- OpenAIRE
- Journal :
- Biology of Blood and Marrow Transplantation
- Accession number :
- edsair.doi.dedup.....e2540ea7ec2421553f4f5db088ef5eee