title: Treatment outcome of elderly patients with aggressive adult T cell leukemia-lymphoma: Nagasaki University Hospital experience.
abstract: VCAP (vincristine, cyclophosphamide, doxorubicin, and prednisone)-AMP (doxorubicin, ranimustine, and prednisone)-VECP (vindesine, etoposide, carboplatin, and prednisone) is a standard regimen for aggressive adult T cell leukemia-lymphoma (ATL). However, the efficacy of this regimen has not been fully elucidated for patients aged 70 years or older. Here, we retrospectively analyzed elderly patients with aggressive ATL at Nagasaki University Hospital between 1994 and 2010 to assess treatment outcomes. Of 148 evaluable patients, 54 were aged 70 years or older at diagnosis. The median survival time (MST) and overall survival (OS) at 2 years in elderly patients were 10.6 months and 22.1%, respectively. Thirty-four patients received VCAP-AMP-VECP as the initial treatment, although the doses were reduced for most patients. In these patients, MST and OS at 2 years were 13.4 months and 26.6%, respectively. Eleven of 34 patients (32%) received maintenance oral chemotherapy after two or three cycles of VCAP-AMP-VECP, and MST and OS at 2 years were 16.7 months and 32.7%, respectively. Our results suggest that the VCAP-AMP-VECP regimen may be effective and that maintenance oral chemotherapy may be considered as a therapeutic option for elderly patients with aggressive ATL.
authors.affiliation: Department of Hematology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Makiyama
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Imaizumi
authors.forename: Hideki
authors.initials: H
authors.lastname: Tsushima
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Taniguchi
authors.forename: Yuji
authors.initials: Y
authors.lastname: Moriwaki
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Sawayama
authors.forename: Daisuke
authors.initials: D
authors.lastname: Imanishi
authors.forename: Jun
authors.initials: J
authors.lastname: Taguchi
authors.forename: Tomoko
authors.initials: T
authors.lastname: Hata
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Tsukasaki
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Miyazaki
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide; D018450:Disease Progression; D004317:Doxorubicin; D005260:Female; D006801:Humans; D060828:Induction Chemotherapy; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D060046:Maintenance Chemotherapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011241:Prednisone; D012189:Retrospective Studies; D016896:Treatment Outcome; D014750:Vincristine
chemical_list: D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone