1
|
Fuji S, Fujiwara H, Nakano N, Wake A, Inoue Y, Fukuda T, Hidaka M, Moriuchi Y, Miyamoto T, Uike N, Taguchi J, Eto T, Tomoyose T, Kondo T, Yamanoha A, Ichinohe T, Atsuta Y, Utsunomiya A. Early application of related SCT might improve clinical outcome in adult T-cell leukemia/lymphoma. Bone Marrow Transplant 2015; 51:205-11. [PMID: 26524263 DOI: 10.1038/bmt.2015.265] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Revised: 08/31/2015] [Accepted: 09/14/2015] [Indexed: 02/08/2023]
Abstract
Allogeneic hematopoietic SCT (allo-HSCT) is a curative treatment for aggressive adult T-cell leukemia/lymphoma (ATLL). Considering the dismal prognosis associated with conventional chemotherapies, early application of allo-HSCT might be beneficial for patients with ATLL. However, no previous study has addressed the optimal timing of allo-HSCT from related donors. Hence, to evaluate the impact of timing of allo-HSCT for patients with ATLL, we retrospectively analyzed data from patients with ATLL who received an allo-HSCT from a related donor. The median age was 52 years. Patients were grouped according to the interval from diagnosis to allo-HSCT: early transplant group, <100 days, n=72; late transplant group, ⩾100 days, n=428. The corresponding constituents of disease status were not statistically different between the two groups (P=0.11). The probability of OS in the early transplant group was significantly higher than that in the late transplant group (4-year OS, 49.3% vs 31.2%). Multivariate analysis revealed that late allo-HSCT was an unfavorable prognostic factor for OS (hazard ratio, 1.46; 95% confidence interval (CI), 1.01-2.11; P=0.04). Despite the limitations of a retrospective study, it might be acceptable to consider early application of allo-HSCT for ATLL.
Collapse
Affiliation(s)
- S Fuji
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - H Fujiwara
- First Department of Internal Medicine, Ehime University Hospital, Ehime, Japan
| | - N Nakano
- Department of Hematology, Imamura Bun-in Hospital, Kagoshima, Japan
| | - A Wake
- Department of Hematology, Toranomon Hospital Kajigaya, Kanagawa, Japan
| | - Y Inoue
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - T Fukuda
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - M Hidaka
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Y Moriuchi
- Department of Hematology, Sasebo City General Hospital, Nagasaki, Japan
| | - T Miyamoto
- Department of Hematology and Oncology, Kyushu University Hospital, Fukuoka, Japan
| | - N Uike
- Department of Hematology, National Kyushu Cancer Center, Fukuoka, Japan
| | - J Taguchi
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Hospital, Nagasaki, Japan
| | - T Eto
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - T Tomoyose
- Second Department of Internal Medicine, Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology, University Hospital, University of the Ryukyus, Okinawa, Japan
| | - T Kondo
- Department of Hematology/Oncology, Kyoto University Hospital, Kyoto, Japan
| | - A Yamanoha
- Department of Haematology, Heart-Life Hospital, Okinawa, Japan
| | - T Ichinohe
- Department of Hematology and Oncology, Hiroshima University Hospital, Hiroshima, Japan
| | - Y Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan.,Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - A Utsunomiya
- Department of Hematology, Imamura Bun-in Hospital, Kagoshima, Japan
| | | |
Collapse
|
2
|
Miyagi T, Itonaga H, Aosai F, Taguchi J, Norose K, Mochizuki K, Fujii H, Furumoto A, Ohama M, Karimata K, Yamanoha A, Taniguchi H, Sato S, Taira N, Moriuchi Y, Fukushima T, Masuzaki H, Miyazaki Y. Successful treatment of toxoplasmic encephalitis diagnosed early by polymerase chain reaction after allogeneic hematopoietic stem cell transplantation: two case reports and review of the literature. Transpl Infect Dis 2015; 17:593-8. [PMID: 25970830 DOI: 10.1111/tid.12401] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 03/31/2015] [Accepted: 04/17/2015] [Indexed: 11/26/2022]
Abstract
Toxoplasmic encephalitis represents a rare, but often fatal infection after allogeneic hematopoietic stem cell transplantation. Polymerase chain reaction (PCR)-based preemptive therapy is considered promising for this disease, but is not routinely applied, especially in low seroprevalence countries including Japan. We encountered 2 cases of toxoplasmic encephalitis after transplantation that were successfully treated. The diagnosis of toxoplasmic encephalitis in these cases was confirmed by PCR testing when neurological symptoms were observed. Both patients received pyrimethamine and sulfadiazine treatments within 2 weeks of the development of neurological symptoms, and remained free of recurrence for 32 and 12 months. These results emphasized the importance of the PCR test and immediate treatment after diagnosis for the management of toxoplasmic encephalitis.
Collapse
Affiliation(s)
- T Miyagi
- Department of Hematology, Heartlife Hospital, Okinawa, Japan
| | - H Itonaga
- Department of Hematology, Sasebo City General Hospital, Sasebo, Japan
| | - F Aosai
- Department of Infection and Host Defense, Graduate School of Medicine, Chiba University, Chiba, Japan.,Department of Infection and Host Defense, Graduate School of Medicine, Shinshu University, Matsumoto, Japan
| | - J Taguchi
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki City, Japan
| | - K Norose
- Department of Infection and Host Defense, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - K Mochizuki
- Department of Infectious Disease, Nagasaki University Hospital, Nagasaki, Japan
| | - H Fujii
- Department of Infectious Disease, Nagasaki University Hospital, Nagasaki, Japan
| | - A Furumoto
- Department of Infectious Disease, Nagasaki University Hospital, Nagasaki, Japan
| | - M Ohama
- Department of Hematology, Heartlife Hospital, Okinawa, Japan
| | - K Karimata
- Department of Hematology, Heartlife Hospital, Okinawa, Japan
| | - A Yamanoha
- Department of Hematology, Heartlife Hospital, Okinawa, Japan
| | - H Taniguchi
- Department of Hematology, Sasebo City General Hospital, Sasebo, Japan
| | - S Sato
- Department of Hematology, Sasebo City General Hospital, Sasebo, Japan
| | - N Taira
- Department of Hematology, Heartlife Hospital, Okinawa, Japan
| | - Y Moriuchi
- Department of Hematology, Sasebo City General Hospital, Sasebo, Japan
| | - T Fukushima
- Laboratory of Hematoimmunology, Department of Clinical Laboratory Sciences, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
| | - H Masuzaki
- Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology (Second Department of Medicine), Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Y Miyazaki
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki City, Japan
| |
Collapse
|