title: Prognostic index for acute- and lymphoma-type adult T-cell leukemia/lymphoma.
abstract: OBJECTIVE
  The prognosis of acute- and lymphoma-type adult T-cell leukemia/lymphoma (ATL) is poor, but there is marked diversity in survival outcomes. The aim of this study was to develop a prognostic index (PI) for acute- and lymphoma-type ATL (ATL-PI).
  
  
  METHODS
  In a retrospective review, data from 807 patients newly diagnosed with acute- and lymphoma-type ATL between January 2000 and May 2009 were evaluated. We randomly divided subjects into training (n = 404) and validation (n = 403) samples, and developed a PI using a multivariable fractional polynomial model.
  
  
  RESULTS
  Median overall survival time (MST) for the 807 patients was 7.7 months. The Ann Arbor stage (I and II v III and IV), performance status (0 to 1 v 2 to 4), and three continuous variables (age, serum albumin, and soluble interleukin-2 receptor [sIL-2R]) were identified as independent prognostic factors in the training sample. Using these variables, a prognostic model was devised to identify different levels of risk. In the validation sample, MSTs were 3.6, 7.3, and 16.2 months for patients at high, intermediate, and low risk, respectively (P < .001; χ(2) = 89.7, 2 df; log-rank test). We also simplified the original ATL-PI according to dichotomizing age at 70 years, serum albumin at 3.5 g/dL, and sIL-2R at 20,000 U/mL and developed an easily calculable PI with prognostic discrimination power (P < .001; χ(2) = 74.2, 2 df; log-rank test).
  
  
  CONCLUSIONS
  The ATL-PI is a promising new tool for identifying patients with acute- and lymphoma-type ATL at different risks.
authors.affiliation: Department of Internal Medicine, Fukuoka University, Jonan, Fukuoka, Japan.
authors.forename: Hiroo
authors.initials: H
authors.lastname: Katsuya
authors.forename: Takeharu
authors.initials: T
authors.lastname: Yamanaka
authors.forename: Kenji
authors.initials: K
authors.lastname: Ishitsuka
authors.forename: Atae
authors.initials: A
authors.lastname: Utsunomiya
authors.forename: Hidenori
authors.initials: H
authors.lastname: Sasaki
authors.forename: Shuichi
authors.initials: S
authors.lastname: Hanada
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Eto
authors.forename: Yukiyoshi
authors.initials: Y
authors.lastname: Moriuchi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Saburi
authors.forename: Masaharu
authors.initials: M
authors.lastname: Miyahara
authors.forename: Eisaburo
authors.initials: E
authors.lastname: Sueoka
authors.forename: Naokuni
authors.initials: N
authors.lastname: Uike
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Yoshida
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Yamashita
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Tsukasaki
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Suzushima
authors.forename: Yuju
authors.initials: Y
authors.lastname: Ohno
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Matsuoka
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Jo
authors.forename: Junji
authors.initials: J
authors.lastname: Suzumiya
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tamura
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000418:Albumins / Q000378:metabolism; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D014408:Biomarkers, Tumor / Q000097:blood; D002423:Cause of Death; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D015375:Receptors, Interleukin-2 / Q000097:blood*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D018709:Statistics, Nonparametric; D016019:Survival Analysis
chemical_list: D000418:Albumins; D014408:Biomarkers, Tumor; D015375:Receptors, Interleukin-2