@article{oai:nagasaki-u.repo.nii.ac.jp:00007399,
 author = {Itonaga, Hidehiro and Taguchi, Jun and Fukushima, Takuya and Tsushima, Hideki and Sato, Shinya and Ando, Koji and Sawayama, Yasushi and Matsuo, Emi and Yamasaki, Reishi and Onimaru, Yasuyuki and Imanishi, Daisuke and Imaizumi, Yoshitaka and Yoshida, Shinichiro and Hata, Tomoko and Moriuchi, Yukiyoshi and Honda, Sumihisa and Miyazaki, Yasushi},
 issue = {4},
 journal = {Biology of Blood and Marrow Transplantation},
 month = {Apr},
 note = {Although allogeneic hematopoietic stem cell transplantation (allo-SCT) is performed as a curative option in adult T cell leukemia-lymphoma (ATL) patients, its high transplantation-related mortality raises a serious issue. The clinical features of infectious complications after transplantation are not well known. To analyze the impact of infections after allo-SCT for ATL, we retrospectively compared infectious complications in 210 patients at 3 institutions in Nagasaki prefecture between 1997 and 2009. There were 91 patients with acute myeloid leukemia (AML), 51 with acute lymphoblastic leukemia/lymphoblastic lymphoma (ALL/LBL), and 68 with ATL. No patient received ganciclovir or foscarvir as prophylaxis, and most patients received antifungal prophylaxis with fluconazole or itraconazole. The cumulative incidence of cytomegalovirus (CMV) infection at 3 years was 69.2% in ATL patients versus 54.4% in AML patients (P = .0255). Cumulative infection-related mortality was significantly higher in ATL patients than in the 2 other groups (ATL versus AML, P = .0496; ATL versus ALL/LBL, P = .0075), and most death-causing pathogens were bacteria and fungus. The appearance of CMV infection was negatively associated with infectious mortality in ATL patients, but the P value for this association was near the borderline of significance (P = .0569). In multivariate analysis, transplantation using unrelated bone marrow and episodes of CMV infection were associated with worse overall survival in ATL patients, but were not in either AML or ALL/LBL patients. Collectively, the impact of infectious complications after transplantation in ATL patients was different from that in AML and ALL/LBL patients, suggesting that a more intensive strategy for infection control in ATL patients is required to reduce infectious mortality., Biology of Blood and Marrow Transplantation, 19(4), pp.607-615; 2013},
 pages = {607--615},
 title = {Distinct Clinical Features of Infectious Complications in Adult T Cell Leukemia/Lymphoma Patients after Allogeneic Hematopoietic Stem Cell Transplantation: A Retrospective Analysis in the Nagasaki Transplant Group},
 volume = {19},
 year = {2013}
}