title: Combination of skin-directed therapy and oral etoposide for smoldering adult T-cell leukemia/lymphoma with skin involvement.
abstract: Approximately 50% of patients with adult T-cell leukemia/lymphoma (ATLL) have skin involvement, and the smoldering, skin lesion-bearing cases are often treated with various skin-directed therapies, such as phototherapy and radiation therapy. Daily oral administration of etoposide plus prednisolone (EP) is also used for smoldering-type ATLL. However, it remains unclear whether these therapies improve patients' survival. We retrospectively analyzed the prognosis of patients with smoldering, skin lesion-bearing ATLL (n = 62), who were treated, as first therapy, with one skin-directed therapy (n = 29), oral EP alone (n = 14) or a combination of skin-directed therapy and oral EP (n = 19). Multivariate analysis revealed that the hazard ratios (HRs) for the overall survival (OS) and progression-free survival (PFS) with the combination therapy were significantly lower than those with the skin-directed therapy (HR 0.1, p = 0.001; HR 0.2, p = 0.002, respectively). These results suggest that the combination of skin-directed therapy and oral EP improves the clinical outcome of patients with smoldering, skin lesion-bearing ATLL.
authors: Department of Dermatology, University of Occupational and Environmental Health, Kitakyushu, Japan. long-ago@med.uoeh-u.ac.jp
authors: Yu
authors: Y
authors: Sawada
authors: Takatoshi
authors: T
authors: Shimauchi
authors: Takashi
authors: T
authors: Yamaguchi
authors: Risa
authors: R
authors: Okura
authors: Kayo
authors: K
authors: Hama-Yamamoto
authors: Haruna
authors: H
authors: Fueki-Yoshioka
authors: Shun
authors: S
authors: Ohmori
authors: Shigenori
authors: S
authors: Yamada
authors: Mayuko
authors: M
authors: Yoshizawa
authors: Kana
authors: K
authors: Hiromasa
authors: Makiko
authors: M
authors: Tajiri
authors: Rieko
authors: R
authors: Kabashima-Kubo
authors: Manabu
authors: M
authors: Yoshioka
authors: Kazunari
authors: K
authors: Sugita
authors: Ryutaro
authors: R
authors: Yoshiki
authors: Ryosuke
authors: R
authors: Hino
authors: Miwa
authors: M
authors: Kobayashi
authors: Kunio
authors: K
authors: Izu
authors: Motonobu
authors: M
authors: Nakamura
authors: Yoshiki
authors: Y
authors: Tokura
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000473:pathology / Q000628:therapy*; D007970:Leukopenia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012867:Skin / Q000473:pathology / Q000528:radiation effects*; D014467:Ultraviolet Therapy / Q000009:adverse effects / Q000379:methods*; D014839:Vomiting / Q000209:etiology
chemical_list: D005047:Etoposide; D011239:Prednisolone