Radiation therapy for the management of patients with HTLV-1-associated adult T-cell leukemia/lymphoma.
Human T-cell leukemia virus type 1-associated adult T-cell leukemia/lymphoma (ATL) typically has survivals measured in months with chemotherapy. One prior published series (1983-1991) assessed local radiotherapy for ATL. Ten consecutive patients with pathologically confirmed ATL treated with radiotherapy were reviewed. Subtypes included acute (n = 7), smoldering (n = 2), and lymphomatous (n = 1). Patients received an average of 2.5 systemic therapy regimens before radiotherapy. Twenty lesions (cutaneous = 10, nodal = 8, extranodal = 2) were treated to a mean of 35.4 Gy/2-3 Gy (range, 12-60 Gy). At 9.0-month mean follow-up (range, 0.1-42.0 months), all lesions symptomatically and radiographically responded, with in-field complete responses in 40.0% (nodal 37.5% vs. cutaneous 50.0%; P = .62). No patient experienced in-field progression. Nine patients developed new/progressive out-of-field disease. Median survival was 17.0 months (3-year survival, 30.0%). No Radiation Therapy Oncology Group acute grade ≥ 3 or any late toxicity was noted. This report is the first to use modern radiotherapy techniques and finds effective local control across ATL subtypes. Radiotherapy should be considered for symptomatic local progression of ATL.
Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Charles B
CB
Simone
John C
JC
Morris
Donn M
DM
Stewart
Nicole E
NE
Urquhart
John E
JE
Janik
Robert J
RJ
Kreitman
Elena
E
Lita
Kevin
K
Conlon
Gilian
G
Wharfe
Thomas A
TA
Waldmann
Aradhana
A
Kaushal
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D015490:HTLV-I Infections / Q000150:complications* / Q000821:virology; D015368:Human T-lymphotropic virus 1; D006801:Humans; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000150:complications / Q000188:drug therapy / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D052016:Mucositis / Q000209:etiology; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods*; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D012871:Skin Diseases / Q000209:etiology; D016019:Survival Analysis; D016896:Treatment Outcome