Promising approach for aggressive NK cell leukaemia with allogeneic haematopoietic cell transplantation
Toshiro Ito1, Hideki Makishima, Hideyuki Nakazawa
1Division of Hematology, Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Objectives:
Aggressive natural killer cell leukaemia (ANKL) is a malignant disorder of mature NK cells with a poor prognosis, for which no effective therapeutic approach has been established. We investigated the role of allogeneic haematopoietic cell transplantion (allo-HCT) in ANKL.
Patients And Methods:
Three patients with ANKL received allo-HCT and seven did not. Epstein-Barr virus (EBV) viral load (VL) of the whole blood was measured with real-time quantitative polymerase chain reaction.
Results:
We transplanted three patients using a myeloablative conditioning regimen with human leucocyte antigen (HLA) two-loci mismatched cord blood (n = 2), or HLA-matched sibling bone marrow (n = 1). In one patient, a second transplantation from the haploidentical mother was also performed at relapse. No patients were in complete remission (CR) at the time of conditioning. After allo-HCT, all three achieved and maintained CR. One died from sepsis and the other relapsed, received the second transplantation and achieved a second CR. EBV VL was quite high in all three at presentation and its significant reduction was observed after allo-HCT. Although their backgrounds were not different from those without allo-HCT, patients with allo-HCT had a better outcome.
Conclusion:
Allo-HCT might be a promising therapy for ANKL with curative potential.
