Although allo-HSCT is the key strategy to cure patients with mature T- and NK-cell lymphomas/leukemia, especially those with relapsed/refractory diseases, there is no consensus strategy for donor selection. We retrospectively analyzed the allo-HSCT of 111 patients in 15 Japanese institutions as a multi-institutional joint research. Thirty-nine patients received bone marrow or peripheral blood stem cell transplantation from related donors (rBMT/rPBSCT), 37 received BMT/PBSCT from unrelated donors (uBMT/uPBSCT), and 35 received cord blood transplantation (CBT). Overall survival (OS) and progression-free survival rates (PFS) at 4 years were 42% and 34%, respectively. Cumulative incidences of relapse and non-relapse mortality were 43% and 25%. In multivariate analysis, CBT showed comparable OS with rBMT/rPBSCT (rBMT/rPBSCT vs. CBT: HR, 1.63; P=0.264) and better OS compared to uBMT/uPBSCT HR, 2.99; P=0.010), with a trend for lower relapse rate (rBMT/rPBSCT vs CBT: HR, 2.60; P=0.010; uBMT/uPBSCT vs CBT: HR, 2.05; P=0.082). This superiority of CBT was more definite in on-disease patients (OS: rBMT/rPBSCT vs CBT: HR, 5.52; P=0.021, uBMT/uPBSCT vs CBT: HR, 6.80; P=0.007). Better disease control was also strongly associated with better OS and PFS with lower relapse rate. In conclusion, allo-HSCT is beneficial for the survival of patients with mature T- and NK-cell lymphomas/leukemia if performed in a timely fashion. Since CBT showed favorable survival with a lower relapse risk, it could be a preferred alternative choice, especially in on-disease patients.Copyright © 2020. Published by Elsevier Inc.
About The Expert
Mizuki Watanabe
Junya Kanda
Yasuyuki Arai
Masakatsu Hishizawa
Momoko Nishikori
Takayuki Ishikawa
Kazunori Imada
Yasunori Ueda
Takashi Akasaka
Akihito Yonezawa
Masaharu Nohgawa
Toshiyuki Kitano
Mitsuru Itoh
Tomoharu Takeoka
Toshinori Moriguchi
Kazuhiro Yago
Nobuyoshi Arima
Naoyuki Anzai
Mitsumasa Watanabe
Tadakazu Kondo
Akifumi Takaori-Kondo
References
PubMed