title: Clinical features and outcome of T-lineage acute lymphoblastic leukemia in adults: a low initial white blood cell count, as well as a high count predict decreased survival rates.
abstract: Although biological and clinical features differ between B-lineage acute lymphoblastic leukemia (ALL) and T-lineage ALL (T-ALL), there have been few reports that focused on the prognosis for T-ALL in adults, primarily due to its rarity. Here, we studied the long-term outcomes and prognostic factors specific for adult T-ALL by combining patient data from the three prospective trials conducted by the Japan Adult Leukemia Study Group (JALSG). Among 559 patients whose immunophenotypes could be evaluated, 87 (15.6%) were identified as T-ALL. Of them, 66 patients (75.8%) achieved complete remission, and relapse occurred in 41 patients. With a median follow-up for surviving patients of 7.5 years, the probability of overall survival was 35.0% at 5 years. Risk factor analysis revealed that serum albumin levels, initial white blood cell (WBC) counts, and age had independent values for predicting survival. For WBC, not only the high-count group (50 x 10(9)l(-1) or higher), but also the low-count group (less than 3 x 10(9)l(-1)) showed a significantly lower survival rates than the intermediate-count group (p=0.0055 and 0.0037, respectively). Although our findings need confirmation, these results will be helpful in the identification of prognostically distinct subgroups within adult T-ALL.
authors.affiliation: Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8550, Japan. myanada@med.nagoya-u.ac.jp
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Yanada
authors.forename: Itsuro
authors.initials: I
authors.lastname: Jinnai
authors.forename: Jin
authors.initials: J
authors.lastname: Takeuchi
authors.forename: Takanori
authors.initials: T
authors.lastname: Ueda
authors.forename: Shuichi
authors.initials: S
authors.lastname: Miyawaki
authors.forename: Motohiro
authors.initials: M
authors.lastname: Tsuzuki
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Hatta
authors.forename: Noriko
authors.initials: N
authors.lastname: Usui
authors.forename: Hideho
authors.initials: H
authors.lastname: Wada
authors.forename: Takeshi
authors.initials: T
authors.lastname: Morii
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Matsuda
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kiyoi
authors.forename: Masaya
authors.initials: M
authors.lastname: Okada
authors.forename: Sumihisa
authors.initials: S
authors.lastname: Honda
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Miyazaki
authors.forename: Ryuzo
authors.initials: R
authors.lastname: Ohno
authors.forename: Tomoki
authors.initials: T
authors.lastname: Naoe
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D019070:Cell Lineage; D002986:Clinical Trials as Topic; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016130:Immunophenotyping; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012074:Remission Induction; D012307:Risk Factors; D015996:Survival Rate; D013601:T-Lymphocytes / Q000473:pathology*