Impact of Residual Disease Localization Before Allogeneic Hematopoietic Stem Cell Transplantation on Outcomes in Adult T-Cell Leukemia-Lymphoma.

Authors

Atsushi Wada, Takafumi Shichijo, Hiro Tatetsu, Shinya Endo, Toshiro Kawakita, Nao Nishimura, Yoshitaka Inoue, Kenji Tokunaga, Taichi Hirano, Takahisa Nakamura, Asami Yamada, Shikiko Ueno, Yusuke Higuchi, Kisato Nosaka, Masao Matsuoka, Jun-Ichirou Yasunaga

Published in

Hematological oncology. Volume 44. Issue 5. Pages e70272.

Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HCT) is the only curative approach for adult T-cell leukemia-lymphoma (ATL). However, preventing post-transplant relapse remains challenging. While pre-transplant disease status is known to be associated with post-transplant outcomes, the impact of residual disease (RD) localization at the time of allo-HCT has not been well described. In this retrospective study of 33 patients with aggressive ATL who underwent allo-HCT, patients were classified into two risk groups based on RD sites: a low-risk group (no lymph node [LN] or extranodal [EN] disease, regardless of the presence of peripheral blood disease) and a high-risk group (presence of LN and/or EN disease). The low-risk group had significantly superior overall survival (OS) and progression-free survival (PFS) compared to the high-risk group, with longer median survival times (OS: 1953 vs. 245 days; PFS: 1177.5 vs. 72 days) and higher 2-year survival rates (OS: 65.0% vs. 11.3%; PFS: 50.0% vs. 8.3%) (p = 0.012 and p = 0.013, respectively). Furthermore, even among patients who had not achieved complete response, RD localization stratified the survival outcomes: the 2-year OS and PFS were 75.0% and 75.0% in the low-risk group, compared with 11.3% and 8.3% in the high-risk group, respectively. In conclusion, RD localization at the time of allo-HCT is a novel prognostic factor, highlighting the need for tailored pre-transplant management for ATL.

PMID:
42800058
Bibliographic data and abstract were imported from PubMed on 27 Sep 2026.

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