Different prognostic factors for survival in acute and lymphomatous adult T-cell leukemia/lymphoma.
BACKGROUND
Adult T-cell leukemia/lymphoma (ATLL) is a clinically aggressive and heterogeneous entity; hence it is likely that different variants of ATLL have different prognostic factors.


METHODS
95 patients with ATLL seen at our institution between 1987 and 2008 were included. Clinical data were compared, according to ATLL variant, using the Mann-Whitney and the Chi-square tests for continuous and categorical variables, respectively. Kaplan-Meier estimates compared using the log-rank test and Cox proportional-hazard test were used for the univariate and multivariate analysis, respectively.


RESULTS
Median age was 61 years with male-to-female ratio of 1.07:1. Patients with acute ATLL were more likely to present with bone marrow, liver and spleen involvement, higher β2-microglobulin and lower albumin levels. Poor performance status, high IPI score, presence of B symptoms, high LDH and low albumin levels were associated with a worse survival in lymphomatous ATLL. High LDH, high β2-microglobulin and high PIT score were associated with worse survival in acute ATLL. In the multivariate analysis, low albumin level and presence of B symptoms were independent factors for worse survival in lymphomatous ATLL, and high β2-microglobulin level was independent factor for worse survival in acute ATLL.


CONCLUSIONS
Aggressive ATLL variants have a distinct, almost mutually exclusive profile of prognostic factors.
Beltran
Brady
B
Department of Oncology and Radiotherapy, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru.
Quiñones
Pilar
P
Morales
Domingo
D
Cotrina
Esther
E
Castillo
Jorge J
JJ
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000418:Albumins / Q000378:metabolism*; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002118:Calcium / Q000378:metabolism; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000378:metabolism*; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000175:diagnosis / Q000378:metabolism / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015996:Survival Rate; D055815:Young Adult; D001613:beta 2-Microglobulin / Q000378:metabolism*
D000418:Albumins; D014408:Biomarkers, Tumor; D001613:beta 2-Microglobulin; D007770:L-Lactate Dehydrogenase; D002118:Calcium