Prognosis of patients with adult T-cell leukemia/lymphoma in Japan: A nationwide hospital-based study.
Yoshitaka ImaizumiMasako IwanagaKisato NosakaKenji IshitsukaKenichi IshizawaShigeki ItoMasahiro AmanoTakashi IshidaNaokuni UikeAtae UtsunomiyaKoichi OhshimaJunji TanakaYoshiki TokuraKensei TobinaiToshiki WatanabeKaoru UchimaruKunihiro Tsukasakinull nullPublished in: Cancer science (2020)
Adult T-cell leukemia/lymphoma (ATL) is a mature T-cell neoplasm and is classified into four subtypes (acute, lymphoma, chronic, and smoldering) according to the Shimoyama classification, established in 1991 through several nationwide surveys based on the clinical diversity of patients diagnosed in 1983-1987 in Japan. Thereafter, no such studies have been conducted. Recently, we conducted a nationwide hospital survey using the method of the 1980s studies, collected baseline data on 996 ATL patients diagnosed in 2010-2011 from 126 hospitals, and reported their unique epidemiological characteristics. Here, we report the follow-up results of registered ATL patients with the goal of evaluating current prognoses and treatment modalities as of 2016-2017. Of 770 evaluable patients, 391 (50.8%) had acute-type, 192 (24.9%) had lymphoma-type, 106 (13.8%) had chronic-type, and 81 (10.5%) had smoldering-type ATL. The initial therapy regimens used for acute/lymphoma-type ATL were vincristine, cyclophosphamide, doxorubicin and prednisone, followed by doxorubicin, ranimustine, and prednisone and then by vindesine, etoposide, carboplatin, and prednisone (VCAP-AMP-VECP)-like in 38.5/41.7% and cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP)-like in 14.6/13.7% of patients. Allogeneic hematopoietic stem cell transplantation was used to treat 15.9/10.4% of acute/lymphoma-type ATL patients. The 4-year survival rates (the median survival time, days) for acute-, lymphoma-, unfavorable chronic-, favorable chronic-, and smoldering-type ATL were 16.8% (252), 19.6% (305), 26.6% (572), 62.1% (1937), and 59.8% (1851), respectively. The 4-year survival rates for acute- and lymphoma-type ATL improved compared with those reported in 1991, but those for chronic- and smoldering-type ATL were not. Further efforts are warranted to develop more efficient therapeutic strategies to improve the prognosis of ATL in Japan.
Keyphrases
- end stage renal disease
- chronic kidney disease
- newly diagnosed
- diffuse large b cell lymphoma
- liver failure
- ejection fraction
- peritoneal dialysis
- healthcare
- drug induced
- respiratory failure
- squamous cell carcinoma
- low dose
- acute myeloid leukemia
- prognostic factors
- stem cells
- randomized controlled trial
- drug delivery
- acute lymphoblastic leukemia
- bone marrow
- machine learning
- emergency department
- intensive care unit
- clinical trial
- young adults
- cancer therapy
- mesenchymal stem cells
- aortic dissection
- radiation therapy
- patient reported outcomes
- acute respiratory distress syndrome
- study protocol
- hepatitis b virus
- mechanical ventilation
- replacement therapy
- phase iii