Outcomes of HTLV-1 Carriers with Diffuse Large B-Cell Lymphoma: A Single-Center Retrospective Matched Cohort Study |
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| Institution: | 1. Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington DC;2. Departamento de Medicina Oncológica Instituto Nacional de Enfermedades Neoplásicas, Lima, Perú;3. Department of Surgery of the University of Massachusetts Medical School, Worcester, MA;4. Department of Lymphoma and Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX;1. Department of Pediatric Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India;2. Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India;3. Department of Pediatric Oncology, Regional Cancer Centre, Trivandrum, Kerala, India;4. Department of Medical Oncology, All India Institute of Medical Sciences, Raipur, India;1. Department of Internal Medicine, Division of Hematology, Oncology, and Blood & Marrow Transplantation, University of Iowa, Iowa City, IA;2. Department of Biostatics, University of Nebraska Medical Center, Omaha, NE;3. Department of Internal Medicine, Rochester General Hospital, Rochester, NY;4. Nobel College, Pokhara University, Kathmandu, Nepal;5. Department of Internal Medicine, Division of Oncology and Hematology, University of Nebraska Medical Center, Omaha, NE;6. Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE;7. Department of Internal Medicine, Section of Hematology, Yale University School of Medicine and Yale Cancer Center, New Haven, CT;8. Department of Medicine, Division of Hematology/Oncology, University of Rochester Medical Center, Rochester, NY;9. Division of Geriatrics, Gerontology and Palliative Medicine, University of Nebraska Medical Center, Omaha, NE;1. Hematology department, Anticancer Centre Léon Bérard, Lyon, France;2. Hematology Department, Saint Louis Hospital, Paris, France;3. Institut Gustave Roussy, Villejuif, France;4. Hématologie Clinique, Dijon University Hospital, Dijon, France;5. Hematology, CHU Caen, Caen, France;6. Hematology, Limoges university hospital, Limoges, France;7. Hematology, CHRU de Lille, Lille, France;8. Service d''hématologie, Institut Universitaire du Cancer de Toulouse - Oncopole, CHU de Toulouse, Toulouse, France;9. Inserm U1245 and Department of Hematology, Centre Henri Becquerel and Normandie Univ UNIROUEN, Rouen, France;10. Hematology, CHU Bordeaux, Pessac, France;11. Hematology, Hopital Mignot, Le Chesnay, France;12. Department of Hematology, University Hospital, Amiens, France;13. Hematology, Henri Mondor Hospital, Creteil, France;14. Hematology, Military Hospital, Clamart, France;15. Hematology, Institut Paoli-Calmettes, Marseille, France;16. Hematology, Avicenne Hospital, APHP, Bobigny, France;17. Hematology, Centre Antoine Lacassagne, Nice, France;18. Hôpital Universitaire Necker-Enfants Malades, Paris, France;19. Hematology, CHU Angers, Angers, France;20. Hematology, CHU Grenoble, Grenoble, France;21. Hematology, CHU Nancy, Nancy, France;22. ALFA Group, Paris, France;23. Haematology Department 1G, Centre Hospitalier Lyon Sud, Pierre Bénite, France;24. Paris-Diderot University, Paris, France;25. Pneumology department, Saint Louis Hospital, AP-HP, Paris, France;1. Department of Medicine, Division of Hematology, The University of North Carolina at Chapel Hill, Chapel Hill, NC;2. Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC;3. Department of Medicine, Division of Hematology-Oncology, University of Rochester, Rochester, NY;1. Department of Hematology, Oncology and Pneumology & University Cancer Center, University Medical Center of the Johannes Gutenberg-University, Mainz, Rhineland-Palatinate, Germany;2. Department of Hematology, Medical University of Lodz, Lodz, Poland;3. Division of Hematology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy |
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| Abstract: | BackgroundThe human T-cell lymphotropic virus type 1 (HTLV-1) is associated with aggressive diseases, such as adult T-cell leukemia/lymphoma (ATLL). However, less is known on the impact of HTLV-1 infection in non-ATLL hematologic malignancies. We aimed to investigate if HTLV-1 carriers with diffuse large B-cell lymphoma (DLBCL) have worse survival outcomes than non-HTLV-1 carriers.Materials and MethodsWe performed a single-center retrospective cohort study by matching HTLV-1 carriers to non-carriers based on age, sex, Ann Arbor stage, and year of diagnosis. Our outcomes of interest were overall survival (OS) and progression-free survival (PFS). The Kaplan-Meier method was used to estimate OS and PFS between carriers and non-carriers. We fitted multivariate Cox regression models to assess the mortality and recurrence/disease progression risk of HTLV-1 infection.ResultsA total of 188 patients, 66 with HTLV-1 infection and 122 without HTLV-1, were included in the study. HTLV-1 carriers had higher extranodal involvement than non-carriers (47% vs. 27%, P = .010). With a median follow-up of 78 months (95% CI: 41-90 months), HTLV-1 carriers had a similar 5 year OS (41% vs. 42%, P = .940) and PFS (34% vs. 32%, P = .691) compared to non-carriers. In the multivariate Cox analysis, HTLV-1 infection was not associated with worse OS (aHR: 0.98, 95% CI: 0.64-1.50) or PFS (aHR: 0.90, 95% CI: 0.60-1.34).ConclusionHTLV-1 carriers with DLBCL did not have worse survival outcomes compared to non-carriers. Our results suggest that clinicians should follow standard guidelines for DLBCL management on HTLV-1 seropositive patients. |
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| Keywords: | Risk factor Overall survival Progression-free survival |
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