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Prognosis of Indolent Adult T-Cell Leukemia/Lymphoma
Authors:Takuro Kameda  Kotaro Shide  Yuki Tahira  Masaaki Sekine  Seiichi Sato  Junzo Ishizaki  Masanori Takeuchi  Keiichi Akizuki  Ayako Kamiunten  Haruko Shimoda  Takanori Toyama  Kouichi Maeda  Kiyoshi Yamashita  Noriaki Kawano  Hiroshi Kawano  Tomonori Hidaka  Hideki Yamaguchi  Yoko Kubuki  Akira Kitanaka  Hitoshi Matsuoka  Kazuya Shimoda
Abstract:A retrospective chart survey of the clinical features of indolent adult T-cell leukemia/lymphoma (ATL) was conducted in the Miyazaki Prefecture, Japan. This study enrolled 24 smoldering-type ATLs, 10 favorable chronic-type ATLs, and 20 unfavorable chronic-type ATLs diagnosed between 2010 and 2018. Among them, 4, 3, and 10 progressed to acute-type ATLs during their clinical course. The median survival time (MST) in smoldering-type ATL and favorable chronic-type ATL was not reached, and their 4-year overall survival (OS) was 73% and 79%, respectively. Compared with this, the prognosis of unfavorable chronic-type ATL was poor. Its MST was 3.32 years, and the 4-year OS was 46% (p = 0.0095). In addition to the three features that determine the unfavorable characteristics of chronic-type ATL, namely, increased lactate dehydrogenase, increased blood urea nitrogen, and decreased albumin, the high-risk category by the indolent ATL-Prognostic Index, which was defined by an increment of soluble interleukin-2 receptor (sIL2-R) of >6000 U/mL, could explain the poor prognosis in indolent ATL patients. The level of sIL-2R might be an indicator of the initiation of therapy for indolent ATL.
Keywords:adult T-cell leukemia/lymphoma   smoldering-type   chronic-type   iATL-PI
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