Journal
INTERNATIONAL JOURNAL OF HEMATOLOGY
Volume 113, Issue 6, Pages 861-871Publisher
SPRINGER JAPAN KK
DOI: 10.1007/s12185-021-03102-0
Keywords
Adult T-cell leukemia; lymphoma; Cord blood transplantation; Non-TBI regimen; Reduced-intensity regimen
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Funding
- Japan Agency for Medical Research and Development (AMED) [20ck0106616h0001, 20ck0106482h0002]
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Cord blood transplantation with non-TBI-RIC using Flu/Mel is a promising treatment strategy for ATLL patients, especially in older patients.
Adult T-cell leukemia/lymphoma (ATLL) is a peripheral T-cell lymphoma with a poor prognosis when treated with chemotherapy alone; therefore, allogeneic stem cell transplantation is a consideration. We attempted cord blood transplantation (CBT) using a reduced-intensity conditioning regimen without total body irradiation (non-TBI-RIC) to allow for the best possible timing of transplantation and improve survival outcomes, particularly in older patients. Forty-eight patients (27 male, 21 female) underwent CBT using fludarabine (Flu) 125 mg/m(2) and melphalan (Mel) 140 mg/m(2) as pre-transplant conditioning. The median age was 32 years (range 44-72), and 21 patients were in complete remission (CR) at the time of CBT. The median duration to neutrophil engraftment (NE) was 19.5 days (range 15-50), with a cumulative incidence of NE of 86.7% at day 50 after CBT. The 1- and 3-year overall survival (OS) rates were 40.4% and 37.7%, respectively. The 3-year OS rate in CR patients was 60.8%, compared with 18.8% in non-CR patients. In ATLL patients, CBT with non-TBI-RIC using Flu/Mel is a promising treatment strategy.
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