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Outcomes of patients with HTLV-1 adult T-cell leukemia/lymphoma (ATLL) after allogeneic SCT: results of the EBMT LWP

Bone Marrow Transplantation (2026)Cite this article

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Abstract

Adult T-cell leukemia/lymphoma (ATLL) is a rare HTLV-1-associated malignancy with a dismal prognosis due to intrinsic chemoresistance and immunosuppression. This retrospective EBMT registry analysis evaluated outcomes of allogeneic stem cell transplantation (allo-SCT) in 73 ATLL patients transplanted between 2004 and 2021. With a median follow-up of 3.9 years, 2-year overall survival (OS) and progression-free survival (PFS) were 49% (95% CI 37–60) and 43% (95% CI 31–54), respectively. Non-relapse mortality was 7% at 2 years, while relapse incidence (RI) was 49.8%. Multivariate analysis identified haploidentical donors as associated with improved OS, while non-CR status at transplant was independently associated with significantly worse PFS (HR 2.93, p = 0.01), OS (HR 4.12, p = 0.002), and RI (HR 2.66, p = 0.04) compared to CR. Our findings suggest that allo-SCT represents a feasible and potentially curative consolidation strategy for ATLL patients, with CR at transplant, younger age, and haploidentical donors being independent predictors of improved survival, supporting the importance of disease control, patient selection, and alternative donor strategies.

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The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors thank all the centers and data managers who contributed data to this study. This study was conducted on behalf of the Lymphoma Working Party of the European Society for Blood and Marrow Transplantation.

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Authors and Affiliations

  1. Clinical Hematology Department, Institut Català d’Oncologia-L’Hospitalet, IDIBELL, Universitat de Barcelona, Barcelona, Spain

    Patricia López-Pereira & Anna Sureda Balari

  2. Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon

    Ali Bazarbachi

  3. Department of Hematology, Institut Imagine, Necker Hospital, Paris Descartes University, Paris, France

    Ambroise Marçais

  4. European Society for Blood and Marrow Transplantation, Paris, France

    Maud Ngoya

  5. European Bone Marrow Transplantation Lymphoma Working Party, Paris, France

    Irma Khvedelidze

  6. University College London Hospitals NHS Foundation Trust, London, United Kingdom

    Arian Laurence

  7. Department of Haematological Medicine, King’s College Hospital NHS Foundation Trust, London, United Kingdom

    Victoria Potter

  8. Hematology and Transplant Unit, Saint-Louis Hospital, APHP, Paris, France

    Flore Sicre de Fontbrune

  9. University of Medicine and Pharmacy Carol Davila, Institutul Clinic Fundeni, Bucharest, Romania

    Alina Daniela Tanase

  10. Imperial College Healthcare NHS Trust, London, United Kingdom

    Lucy Cook

  11. Birmingham Centre for Cellular Therapy and Transplant (BCCTT), Birmingham, United Kingdom

    Sridhar Chaganti

  12. Royal Marsden NHS Foundation Trust, London, United Kingdom

    Emma Nicholson

  13. Erasmus MC Cancer Institute, Rotterdam, Netherlands

    Yasmina Serroukh

  14. Yorkshire Blood & Marrow Transplant Program, Leeds, United Kingdom

    Jennifer Clay

  15. Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France

    Hélène Labussière-Wallet

  16. Hematology and Bone Marrow Transplantation Unit, I.R.C.C.S. San Raffaele Scientific Institute, Milan, Italy

    Fabio Ciceri

  17. Department of Hematology and Stem Cell Transplantation, Helios Klinikum Berlin-Buch, Berlin, Germany

    Bertram Glass

  18. Hematology, Necker Hospital, Greater Paris University Hospitals (AP-HP), Paris, France

    Olivier Hermine

  19. Lymphoma Working Party, On behalf of the EBMT (European Group for Blood and Marrow Transplantation), Barcelona, Spain

    Anna Sureda Balari

Authors
  1. Patricia López-Pereira
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  2. Ali Bazarbachi
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  3. Ambroise Marçais
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  7. Victoria Potter
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  8. Flore Sicre de Fontbrune
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  10. Lucy Cook
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  15. Hélène Labussière-Wallet
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  19. Anna Sureda Balari
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Contributions

PLP designed the study, collected and analyzed data, and wrote the manuscript. MN and IK performed statistical analysis. AB and ASB designed and supervised the study and critically revised the manuscript. AM, AL, VP, FSdF, ADT, LC, SC, EN, YS, JC, HLW, FC, BG, and OH collected clinical data and revised the manuscript.

Corresponding author

Correspondence to Patricia López-Pereira.

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Competing interests

The authors declare no competing interests.

Ethics

This retrospective study was conducted according to Good Clinical Practice and following the Declaration of Helsinki. It was approved by the Lymphoma Working Party (LWP) of the EBMT.

Patient consent statement

An informed consent was designed, and it was signed, when suitable, by the subjects analyzed in this study.

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López-Pereira, P., Bazarbachi, A., Marçais, A. et al. Outcomes of patients with HTLV-1 adult T-cell leukemia/lymphoma (ATLL) after allogeneic SCT: results of the EBMT LWP. Bone Marrow Transplant (2026). https://doi.org/10.1038/s41409-025-02783-z

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