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Annals of Oncology Advance Access originally published online on January 15, 2009
Annals of Oncology 2009 20(4):715-721; doi:10.1093/annonc/mdn696
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© The Author 2009. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

hematologic malignancies

The International Prognostic Index predicts outcome in aggressive adult T-cell leukemia/lymphoma: analysis of 126 patients from the International Peripheral T-cell Lymphoma Project

J. Suzumiya1,*, K. Ohshima2, K. Tamura3, K. Karube2, N. Uike4, K. Tobinai5, R. D. Gascoyne6, J. M. Vose7, J. O. Armitage7, D. D. Weisenburger8 and for the International Peripheral T-cell Lymphoma Project

1 Department of Internal Medicine, Fukuoka University Chikushi Hospital, Fukuoka
2 Department of Pathology, Kurume University, Fukuoka
3 Department of Hematology/Oncology, Fukuoka University, Fukuoka
4 Department of Hematology, National Kyushu Cancer Center, Fukuoka, Japan
5 Hematology and Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo
6 Department of Pathology, British Columbia Cancer Agency, Vancouver, Canada
7 Department of Internal Medicine
8 Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, USA

* Correspondence to: Dr J. Suzumiya, Second Department of Internal Medicine, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyoin Chikushino-shi, Fukuoka 818-8502, Japan. Tel: +81-92-921-1011; Fax: +81-92-928-0856; E-mail: junsuzu{at}fukuoka-u.ac.jp

Background: The International Peripheral T-cell Lymphoma Project was organized to better understand the T-cell and natural killer (NK) cell lymphomas, and our task is to present the clinicopathologic correlations and therapeutic results for adult T-cell leukemia/lymphoma (ATL).

Patients and methods: Among 1153 patients with T-cell or NK cell lymphomas, 126 patients (9.6%) with ATL were represented in this project. All were categorized as aggressive ATL, i.e. acute or lymphoma type, and 87% fell into the lymphoma type.

Results: The median age was 62 years and the male to female ratio was 1.2 : 1. Significant prognostic factors for overall survival (OS) by univariate analysis were the presence of B symptoms (P = 0.018), platelet count <150 x 109/l (P = 0.065), and the International Prognostic Index (IPI; P = 0.019). However, multivariate analysis indicated that only the IPI was an independent predictor of OS. Combination chemotherapy including anthracyclines was given as the initial therapy in 109 of the 116 patients (94%) who received treatment, and the overall and complete response rates were 70% and 34%, respectively. However, there was no survival benefit for those receiving an anthracycline-containing regimen.

Conclusion: Patients with aggressive ATL have a poor clinical outcome and the IPI is a useful model for predicting outcome in ATL of the lymphoma type.

Key words: ATL, leukemia, lymphoma, T-cell, prognostic index, international

Received for publication September 16, 2008. Accepted for publication September 30, 2008.


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