Application Timing-Dependent Impact of Donor Source on Outcomes After Allogeneic Hematopoietic Stem Cell Transplantation for Adult T-Cell Leukemia/Lymphoma.

Authors

Hidehiro Itonaga, Takuya Fukushima, Hiroyuki Muranushi, Nobuaki Nakano, Yoshitaka Inoue, Masahito Tokunaga, Takahiro Fukuda, Tetsuya Eto, Toshiro Kawakita, Takeharu Kato, Jun Ishikawa, Makoto Yoshimitsu, Naoyuki Uchida, Yasuo Mori, Masuho Saburi, Youko Suehiro, Masao Ogata, Yoshinobu Kanda, Kenji Ishitsuka, Yoshiko Atsuta, Shigeo Fuji

Published in

Hematological oncology. Volume 44. Issue 4. Pages e70220.

Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is usually performed as a curative treatment for adult T-cell leukemia/lymphoma (ATL), following first-line chemotherapy. We conducted a nationwide retrospective study to examine the prognostic impact of donor sources based on transplantation application timings: human leukocyte antigen (HLA)-matched related donor (MRD; n = 253), unrelated donor (URD; n = 656), unrelated cord blood (U-CB; n = 599), and HLA-haploidentical related donor with post-transplant cyclophosphamide (PT-CY; n = 166). In patients with the early application of allo-HSCT (< 100 days from diagnosis), the multivariate analysis showed no significant difference in overall mortality (OM) among all donor sources. Regarding the middle timing of allo-HSCT (100-179 days), the U-CB group showed higher OM than the MRD group (hazard ratio [HR], 1.37; p = 0.013), while the URD and PT-CY groups showed no significant difference in OM with the MRD group. Concerning the late timing of allo-HSCT (180-270 days), the U-CB (HR, 1.88; p = 0.005) and PT-CY groups (HR, 1.90; p = 0.043) showed higher OM than the MRD group, whereas the URD group exhibited comparable OM to the MRD group. The present study demonstrated the differential impact of the graft source based on the timing of allo-HSCT for ATL; therefore, it is important to select an optimal alternative donor based on application timing.

PMID:
42446167
Bibliographic data and abstract were imported from PubMed on 14 Jul 2026.

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