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However, preventing post\u2010transplant relapse remains challenging. While pre\u2010transplant disease status is known to be associated with post\u2010transplant outcomes, the impact of residual disease (RD) localization at the time of allo\u2010HCT has not been well described. In this retrospective study of 33 patients with aggressive ATL who underwent allo\u2010HCT, patients were classified into two risk groups based on RD sites: a low\u2010risk group (no lymph node [LN] or extranodal [EN] disease, regardless of the presence of peripheral blood disease) and a high\u2010risk group (presence of LN and\/or EN disease). The low\u2010risk group had significantly superior overall survival (OS) and progression\u2010free survival (PFS) compared to the high\u2010risk group, with longer median survival times (OS: 1953 vs. 245\u00a0days; PFS: 1177.5 vs. 72\u00a0days) and higher 2\u2010year survival rates (OS: 65.0% vs. 11.3%; PFS: 50.0% vs. 8.3%) (\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a00.012 and\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a00.013, respectively). Furthermore, even among patients who had not achieved complete response, RD localization stratified the survival outcomes: the 2\u2010year OS and PFS were 75.0% and 75.0% in the low\u2010risk group, compared with 11.3% and 8.3% in the high\u2010risk group, respectively. In conclusion, RD localization at the time of allo\u2010HCT is a novel prognostic factor, highlighting the need for tailored pre\u2010transplant management for ATL.\n                  <\/jats:p>","DOI":"10.1002\/hon.70272","type":"journal-article","created":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T18:16:50Z","timestamp":1790446610000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Residual Disease Localization Before Allogeneic Hematopoietic Stem Cell Transplantation on Outcomes in Adult T\u2010Cell Leukemia\u2010Lymphoma"],"prefix":"10.1002","volume":"44","author":[{"given":"Atsushi","family":"Wada","sequence":"first","affiliation":[{"name":"Department of Hematology Rheumatology and Infectious Diseases Kumamoto University Hospital  Kumamoto 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Rheumatology and Infectious Diseases Kumamoto University Hospital  Kumamoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5669-3793","authenticated-orcid":false,"given":"Shikiko","family":"Ueno","sequence":"additional","affiliation":[{"name":"Department of Hematology Rheumatology and Infectious Diseases Kumamoto University Hospital  Kumamoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4888-3777","authenticated-orcid":false,"given":"Yusuke","family":"Higuchi","sequence":"additional","affiliation":[{"name":"Department of Hematology National Hospital Organization Kumamoto Medical Center  Kumamoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6682-2451","authenticated-orcid":false,"given":"Kisato","family":"Nosaka","sequence":"additional","affiliation":[{"name":"Department of Hematology Rheumatology and Infectious Diseases 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