Stem Cell Transplantation Autologous stem cell transplantation Acute and lymphomatous ATL

At least 13 patients with ATL (nine acute and four lymphoma) have received an autologous stem cell transplantation (ASCT).51-59 Median age was 49 years (range 33-65 years); 61.5% of patients had refractory disease, partial responses (PRs), or were in early relapse at the time of transplant. All patients achieved or maintained either a CR (92.3%) or a PR (7.7%) post-ASCT. Although disappearance of the monoclonal band by Southern blot analysis and by inverse PCR after ASCT can be demonstrated in a few cases, the durability of remission is unclear.5152 Clinical outcomes have been complicated by early recurrence and fatal infections, with OS of 0.47-12+ months and only 8% of patients surviving >12 months post-ASCT. CD34+ selection does not improve results; Southern blot analysis of the peripheral blood stem cells (PBSCs) revealed contamination with HTLV-1-infected cells57 and have been documented relapses despite.52'53'57 59 ASCT does not have a role in the treatment of patients with ATL, outside of an investi-gational trial.

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