Different prognostic factors for survival in acute and lymphomatous adult T-cell leukemia/lymphoma |
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Authors: | Brady BeltranPilar Quiñ ones,Domingo MoralesEsther Cotrina,Jorge J. Castillo |
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Affiliation: | a Department of Oncology and Radiotherapy, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru b Department of Pathology, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru c Nursing Department, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru d Division of Hematology and Oncology, The Miriam Hospital, The Warren Alpert Medical School of Brown University, 164 Summit Ave., Providence, RI 02906, USA |
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Abstract: | Introduction: Adult T-cell leukemia/lymphoma (ATLL) is a clinically aggressive and heterogeneous entity; hence it is likely that different variants of ATLL have different prognostic factors. Methods: 95 patients with ATLL seen at our institution between 1987 and 2008 were included. Clinical data were compared, according to ATLL variant, using the Mann-Whitney and the Chi-square tests for continuous and categorical variables, respectively. Kaplan-Meier estimates compared using the log-rank test and Cox proportional-hazard test were used for the univariate and multivariate analysis, respectively. Results: Median age was 61 years with male-to-female ratio of 1.07:1. Patients with acute ATLL were more likely to present with bone marrow, liver and spleen involvement, higher β2-microglobulin and lower albumin levels. Poor performance status, high IPI score, presence of B symptoms, high LDH and low albumin levels were associated with a worse survival in lymphomatous ATLL. High LDH, high β2-microglobulin and high PIT score were associated with worse survival in acute ATLL. In the multivariate analysis, low albumin level and presence of B symptoms were independent factors for worse survival in lymphomatous ATLL, and high β2-microglobulin level was independent factor for worse survival in acute ATLL. Conclusions: Aggressive ATLL variants have a distinct, almost mutually exclusive profile of prognostic factors. |
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Keywords: | Adult T-cell leukemia/lymphoma ATLL Prognostic factors IPI score PIT score |
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