Real-world time trends of survival after post-transplant relapse of adult T-cell leukemia/lymphoma

Post-transplant refractory/relapsed adult T-cell leukemia/lymphoma (R/R ATL) is associated with poor outcomes. Over time, advances have been made in transplant modalities, novel targeted agents, and supportive care; however, it is unclear whether these advances have improved survival outcomes of post-transplant R/R ATL. A study by the Japanese Society for Transplantation and Cellular Therapy evaluated the real-world survival outcomes of 1146 patients over a 24-year period, using a nationwide database. The period was divided into three groups: 1999-2010 (early period), 2011-2016 (middle period), and 2017-2022 (late period). In patients with refractory ATL, multivariate analyses showed no significant difference in overall mortality (OM) between the early and middle periods, but a significantly lower OM in the late period than in the early period (HR 0.73; 95% CI 0.55-0.96). In patients with relapsed ATL, OM after post-transplant relapse was significantly lower in the middle (HR 0.62; 95% CI 0.48-0.80) and late periods (0.68; 0.52-0.90) than in the early period. The authors conclude that recent advances appear to have contributed to increased opportunities for therapeutic interventions, leading to improved survival outcomes in patients with post-transplant R/R ATL (graphical abstract).