Outcomes in human T-cell leukemia virus type I carriers after hematopoietic stem cell transplantation for diseases other than adult T cell leukemia/lymphoma: a Japanese national surveyResearch in context

• Main Authors: Nobuaki Nakano (Author), Hideki Nakasone (Author), Shigeo Fuji (Author), Akihito Shinohara (Author), Ritsuro Suzuki (Author), Atae Utsunomiya (Author), Tetsuya Eto (Author), Satoko Morishima (Author), Kazuhiro Ikegame (Author), Yasutaka Kakinoki (Author), Ken-ichi Matsuoka (Author), Yasuo Mori (Author), Youko Suehiro (Author), Naoyuki Uchida (Author), Ayumu Ito (Author), Noriko Doki (Author), Yukiyasu Ozawa (Author), Junya Kanda (Author), Yoshinobu Kanda (Author), Takahiro Fukuda (Author), Yoshiko Atsuta (Author), Masao Ogata (Author)
• Format: Book
• Published: Elsevier, 2023-11-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2666-6065; 10.1016/j.lanwpc.2023.100902
• Keywords: HTLV-1; Stem cell transplantation; Diseases other than ATL; Public aspects of medicine; RA1-1270
• Source: The Lancet Regional Health. Western Pacific, Vol 40, Iss , Pp 100902- (2023)

Summary: Background: Human T-cell leukemia virus type I (HTLV-1) is a retrovirus known to cause adult T-cell leukemia/lymphoma (ATL). There are few reports on hematopoietic stem cell transplantation (HSCT) for d HTLV-1 carriers with diseases other than ATL. Methods: A total of 25,839 patients (24,399 adults and 1440 children) with pre-transplant HTLV-1 serostatus information recorded in the Japanese National Survey Database who had undergone their first HSCT were analyzed. We investigated the overall survival (OS), transplant-related mortality (TRM), and disease-related mortality (DRM) after HSCT in relation to HTLV-1 serologic status. Findings: Three hundred and forty-eight patients were HTLV-1 antibody carriers. The number of HTLV-1 carriers and noncarriers among adult patients who received allogeneic HSCT (allo-HSCT) or autologous HSCT (auto-HSCT) was 237/15,777 and 95/8920, respectively, and was 16/1424 among pediatric patients who received allo-HSCT. No pediatric HTLV-1 carrier recipients undergoing auto-HSCT were identified. There were no significant differences between HTLV-1 carriers and non-carriers regarding stem cell source, disease risk, or HCT-CI score prior to allo-HSCT. Multivariate analysis of OS (P = 0.020) and TRM (P = 0.017) in adult patients showed that HTLV-1 positive status was a significant prognostic factor. In children, TRM was significantly higher (P = 0.019), but OS was not significantly different. In adult patients who underwent auto-HSCT, HTLV-1 positive status was not a significant prognostic factor. In adult allo-HSCT patients, cytomegalovirus reactivation was significantly more common in HTLV-1 carriers (P = 0.001). Interpretation: HTLV-1 antibody positivity was shown to have a poor prognosis in OS and TRM after allo-HSCT in adult patients and in TRM after allo-HSCT in pediatric patients. Funding: This work was supported in part by the practical research programs of the Japan Agency for Medical Research and Development (AMED) under grant number 17ck0106342h0001.