4.6 Article

Chromosomal defects and survival in patients with adult T-cell leukemia/lymphoma after allogeneic HSCT

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BLOOD ADVANCES
卷 5, 期 2, 页码 475-486

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DOI: 10.1182/bloodadvances.2020003639

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  1. Practical Research Programs of the Japan Agency for Medical Research and Development (AMED) [JP19ck0106342h0003, JP19ek0510023h0002]

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This study investigated the impact of chromosomal abnormalities on the survival of ATL patients after allo-HSCT, and found that certain structural breakpoints were independent risk factors for overall survival and ATL-related death.
Adult T-cell leukemia/lymphoma (ATL) cells frequently exhibit chromosomal abnormalities, including numerical aberrations and structural defects. However, no studies have examined the correlation between these abnormalities and survival in patients with ATL after allogeneic HSCT (allo-HSCT). In this study, 300 patients with ATL (median age, 55 years; range, 24-74) who were registered in a Japanese nationwide registry database were analyzed. The majority (n = 183) had acute ATL. Specimens for chromosomal analysis were collected from bone marrow (n = 166), lymph nodes (n = 86), peripheral blood (n = 41), and other locations (n = 7). In survival analyses, breakpoints at 2q (hazard ratio [HR] 1.63; 95% confidence interval [CI], 1.12-2.38; P = .012) and Sq (HR, 2.18; 95% CI, 1.25-3.80; P = .006) were significantly poor prognostic factors for overall survival (OS). In terms of ATL-related death, loss of chromosome 14 and breakpoints at 3p, 1q, 5q, and 6q were extracted as significantly poor prognostic factors. Moreover, complex karyotypes were associated with ATL-related death. This study of the survival impact of chromosomal abnormalities in patients with An after allo-HSCT demonstrated that several structural breakpoints were independent risk factors for OS and ATL-related death.

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