1062O - A nationwide survey of adult t-cell leukemia/lymphoma (ATL) newly diagnosed over the last decade in Japan

Date 01 October 2012
Event ESMO Congress 2012
Session Hematological malignancies
Topics Leukaemia
Lymphomas
Presenter Kazuo Tamura
Authors H. Katsuya1, K. Ishitsuka2, A. Utsunomiya3, S. Hanada4, T. Eto5, Y. Moriuchi6, Y. Saburi7, T. Yamanaka8, J. Suzumiya9, K. Tamura10
  • 1Medical Oncology, Hematology,and Infectious Diseas, Fukuoka University, 8140180 - Fukuoka/JP
  • 2Department Of Medicine, Division Of Medical Oncology, Hematology And Infectious Diseases, Fukuoka University, Fukuoka/JP
  • 3Hematology, Imamura Bun-in Hospital, Kagoshima/JP
  • 4Hematology, National Hospital Organization Kagoshima Medical Center, Kagoshima/JP
  • 5Hematology, Hamanomachi Hospital, Fukuoka/JP
  • 6Hematology, Sasebo City General Hospital, Sasebo/JP
  • 7Hematology, Oita Prefectural Hospital, Oita/JP
  • 8Research Center For Innovative Oncology, National Cancer Center Hospital East, Kashiwa/JP
  • 9Cancer Center, Shimane University, Izumo/JP
  • 10Fukuoka University, Fukuoka/JP

Abstract

Introduction

ATL is a malignancy of mature T-lymphocytes caused by human T-lymphotropic virus type I (HTLV-1), and it is classified into 4 clinical subtypes, i.e. acute, lymphoma, chronic, and smoldering type according to the analysis of the former nationwide survey performed in late 80's. During the 2 decades after this analsysis, treatment for ATL has improved, e.g. intensive sequential combination chemotherapy and allogeneic hematopoietic stem cell transplantation (HSCT). We therefore performed a nationwide survey to know the outcome of ATL patients newly diagnosed during the last decade.

Patients and methods

The clinical data was collected retrospectively from the medical record of patients who were diagnosed as ATL between 2000 and 2009 in participating institutions. Approval of this study was obtained from the Ethics Committee and Institutional Review Board of Fukuoka University where the central office is located and at each participating center based on their institutional policies.

Results

A total of 1552 patients' survey form was submitted from 81 institutions across Japan. Fifty-four patients were excluded due to missing data, and the remaining 1498 were analyzed. The median survival time (MST) of 897 for acute type and that of 355 for lymphoma type were 8.3 and 10.6 months, and overall survival (OS) rates at 5 years were 9% and 13%, respectively. Fifty % of patients had received CHOP/CHOP-like regimen, 31 % had VCAP-AMP-VECP regimen, and single agent was used in 6% of the patients. The number of patients with allogeneic HSCT was 227 (46% from a sibling donor and 51% from an unrelated donor), a half of them were transplanted at first remission. The MST and OS at 5 years from transplantation were 5 months and 25%, respectively. The MST of 172 for chronic and that of 74 for smoldering type were 30.3 and 36.7 months, respectively.

Conclusion

The prognosis of acute and lymphoma type was still poor despite the recent progress in treatment modalities, and it is of disappointment that their therapeutic outcome was not remarkably improved as compared to former survey. It is also a surprise that the prognosis of smoldering type is not good as expected from the previous survey. To note, 25% of patients who underwent transplantation experienced a long survival, but it should be validated by the prospective study.

Disclosure

All authors have declared no conflicts of interest.