Outcome of Stem Cell Transplantation in HTLV-1-Associated North American Adult T-Cell Leukemia/Lymphoma

• DOI: 10.1007/s44228-023-00032-y
• Publication Date: 2023-03-26T23:21:02Z
• Authors: Abdul-Hamid Bazar...; Daniel Reef; Hiba Narvel; Riya Patel; Rama Al Hamed; Sindhu Vikash; Karun Neupane; Eleftheria Atalla; Astha Thakkar; Shafia Rahman; Urvi Shah; Diego Adrianzen-H...; Ryann Quinn; Sumaira Zareef; Emma Rabinovich; Alyssa De Castro; Felisha Joseph; Kailyn Gillick; Jennat Mustafa; Fariha Khatun; Amanda Lombardo; Latoya Townsend-N...; Michelly Abreu; Nicole Chambers; Richard Elkind; Yang Shi; Yanhua Wang; Olga Derman; Kira Gritsman; Ulrich Steidl; Mendel Goldfinger; Noah Kornblum; Aditi Shastri; Ioannis Mantzaris; Liza Bachier-Rodr...; Nishi Shah; Dennis Cooper; Amit Verma; Bihui Hilda Ye; Murali Janakiram; Roberto Alejandro...
• Keywords: Autologous stem-cell transplantation; Adult T-cell leukemia/lymphoma

Adult T-cell leukemia/lymphoma (ATLL) remains challenging to treat and has dismal outcome. Allogeneic stem-cell transplantation (allo-SCT) promising results, but data remain scarce. In this single-center retrospective analysis of 100 patients with ATLL from north America (67 acute, 22 lymphomatous), 17 underwent allo-SCT 5 autologous SCT (ASCT), a median follow-up 65 months. Post-transplant 3-years relapse incidence (RI) non-relapse mortality (NRM) were 51% 37%, respectively, 3-year progression-free survival (PFS) overall (OS) 31% 35%, respectively. ASCT 1-year RI was 80% compared 30% in (p = 0.03). After adjusting for immortal-time bias, had significantly improved OS (HR 0.4, p 0.01). exploratory multivariate analysis, achieving first complete response Karnofsky score ≥ 90 better outcomes, as did Black patients, Hispanics, who worse transplanted 14 died within 2 years, 4 which recipients. Our are the largest transplant cohort presented date outside Japan Europe. We show that allo-SCT, not ASCT, is valid option select can induce long term survival, 40% alive after more than years.