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Blood. 2015 Dec 10;126(24):2570-7. doi: 10.1182/blood-2015-03-632489. Epub 2015 Sep 11.

Treatment and survival among 1594 patients with ATL.

Author information

1
Division of Medical Oncology, Hematology and Infectious Diseases, Department of Medicine, School of Medicine, Fukuoka University, Fukuoka, Japan;
2
Department of Hematology, Imamura Bun-in Hospital, Kagoshima, Japan;
3
Department of Hematology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan;
4
Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan;
5
Department of Hematology, Sasebo City General Hospital, Sasebo, Japan;
6
Department of Hematology, Oita Prefectural Hospital, Oita, Japan;
7
Department of Internal Medicine, Karatsu Red Cross Hospital, Karatsu, Japan;
8
Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan;
9
Department of Hematology, National Kyushu Cancer Center, Fukuoka, Japan;
10
Department of Hematology, National Hospital Organization Nagasaki Medical Center, Omura, Japan;
11
Department of Internal Medicine, Miyazaki Prefectural Hospital, Miyazaki, Japan;
12
Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan;
13
Department of Hematology, Kumamoto Shinto General Hospital, Kumamoto, Japan;
14
Department of Internal Medicine, Kitakyushu Municipal Medical Center, Kitakyushu, Japan;
15
Department of Internal Medicine, Koga General Hospital, Miyazaki, Japan;
16
Department of Hematology, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan;
17
Department of Dermatology, Miyazaki University, Miyazaki, Japan;
18
Department of Dermatology, University of Occupational and Environmental Health, Kitakyushu, Japan;
19
Clinical Research Institute, National Kyushu Cancer Center, Fukuoka, Japan;
20
Department of Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan; and.
21
Cancer Center, Shimane University Hospital, Izumo, Japan.

Abstract

Adult T-cell leukemia/lymphoma (ATL) is a malignancy of mature T lymphocytes caused by human T-lymphotropic virus type I. Intensive combination chemotherapy and allogeneic hematopoietic stem cell transplantation have been introduced since the previous Japanese nationwide survey was performed in the late 1980s. In this study, we delineated the current features and management of ATL in Japan. The clinical data were collected retrospectively from the medical records of patients diagnosed with ATL between 2000 and 2009, and a total of 1665 patients' records were submitted to the central office from 84 institutions in Japan. Seventy-one patients were excluded; 895, 355, 187, and 157 patients with acute, lymphoma, chronic, and smoldering types, respectively, remained. The median survival times were 8.3, 10.6, 31.5, and 55.0 months, and 4-year overall survival (OS) rates were 11%, 16%, 36%, and 52%, respectively, for acute, lymphoma, chronic, and smoldering types. The number of patients with allogeneic hematopoietic stem cell transplantation was 227, and their median survival time and OS at 4 years after allogeneic hematopoietic stem cell transplantation was 5.9 months and 26%, respectively. This study revealed that the prognoses of the patients with acute and lymphoma types were still unsatisfactory, despite the recent progress in treatment modalities, but an improvement of 4-year OS was observed in comparison with the previous survey. Of note, one-quarter of patients who could undergo transplantation experienced long survival. It is also noted that the prognosis of the smoldering type was worse than expected.

Comment in

PMID:
26361794
DOI:
10.1182/blood-2015-03-632489
[Indexed for MEDLINE]

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