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Impact of HLA-mismatched unrelated transplantation in patients with adult T-cell leukemia/lymphoma.
- Source :
-
Bone marrow transplantation [Bone Marrow Transplant] 2023 Sep; Vol. 58 (9), pp. 980-990. Date of Electronic Publication: 2023 May 12. - Publication Year :
- 2023
-
Abstract
- This Japanese nationwide retrospective study investigated the impact of HLA-mismatched unrelated transplantation for adult T-cell leukemia-lymphoma (ATL) patients who received transplantation between 2000 and 2018. We compared 6/6 antigen-matched related donor (MRD), 8/8 allele-matched unrelated donor (8/8MUD), and 1 allele-mismatched unrelated donor (7/8MMUD) in the graft-versus-host direction. We included 1191 patients; 449 (37.7%) were in the MRD group, 466 (39.1%) in the 8/8MUD group, and 276 (23.7%) in the 7/8MMUD group. In the 7/8MMUD group, 97.5% of patients received bone marrow transplantation, and no patients received post-transplant cyclophosphamide. The cumulative incidences of non-relapse mortality (NRM) and relapse at 4 years, and the probabilities of overall survival at 4 years in the MRD group were 24.7%, 44.4%, 37.5%, in the 8/8MUD group were 27.2%, 38.2%, and 37.9%, and in the 7/8MMUD group were 34.0%, 34.4%, and 35.3%, respectively. The 7/8MMUD group had a higher risk of NRM (hazard ratio (HR) 1.50 [95% CI, 1.13-1.98; Pā=ā0.005]) and a lower risk of relapse (HR 0.68 [95% CI, 0.53-0.87; Pā=ā0.003]) than the MRD group. The donor type was not a significant risk factor for overall mortality. These data suggest that 7/8MMUD is an acceptable alternative donor when an HLA-matched donor is unavailable.<br /> (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)
- Subjects :
- Adult
Humans
Transplantation, Homologous adverse effects
Retrospective Studies
Unrelated Donors
Recurrence
Hematopoietic Stem Cell Transplantation adverse effects
Leukemia-Lymphoma, Adult T-Cell therapy
Leukemia-Lymphoma, Adult T-Cell complications
Lymphoma complications
Graft vs Host Disease etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1476-5365
- Volume :
- 58
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Bone marrow transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 37173417
- Full Text :
- https://doi.org/10.1038/s41409-023-02002-7