title: Treatment and survival among 1594 patients with ATL.
abstract: Adult T-cell leukemia/lymphoma (ATL) is a malignancy of mature T lymphocytes caused by human T-lymphotropic virus type I. Intensive combination chemotherapy and allogeneic hematopoietic stem cell transplantation have been introduced since the previous Japanese nationwide survey was performed in the late 1980s. In this study, we delineated the current features and management of ATL in Japan. The clinical data were collected retrospectively from the medical records of patients diagnosed with ATL between 2000 and 2009, and a total of 1665 patients' records were submitted to the central office from 84 institutions in Japan. Seventy-one patients were excluded; 895, 355, 187, and 157 patients with acute, lymphoma, chronic, and smoldering types, respectively, remained. The median survival times were 8.3, 10.6, 31.5, and 55.0 months, and 4-year overall survival (OS) rates were 11%, 16%, 36%, and 52%, respectively, for acute, lymphoma, chronic, and smoldering types. The number of patients with allogeneic hematopoietic stem cell transplantation was 227, and their median survival time and OS at 4 years after allogeneic hematopoietic stem cell transplantation was 5.9 months and 26%, respectively. This study revealed that the prognoses of the patients with acute and lymphoma types were still unsatisfactory, despite the recent progress in treatment modalities, but an improvement of 4-year OS was observed in comparison with the previous survey. Of note, one-quarter of patients who could undergo transplantation experienced long survival. It is also noted that the prognosis of the smoldering type was worse than expected.
authors.affiliation: Division of Medical Oncology, Hematology and Infectious Diseases, Department of Medicine, School of Medicine, Fukuoka University, Fukuoka, Japan;
authors.forename: Hiroo
authors.initials: H
authors.lastname: Katsuya
authors.affiliation: Division of Medical Oncology, Hematology and Infectious Diseases, Department of Medicine, School of Medicine, Fukuoka University, Fukuoka, Japan;
authors.forename: Kenji
authors.initials: K
authors.lastname: Ishitsuka
authors.affiliation: Department of Hematology, Imamura Bun-in Hospital, Kagoshima, Japan;
authors.forename: Atae
authors.initials: A
authors.lastname: Utsunomiya
authors.affiliation: Department of Hematology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan;
authors.forename: Shuichi
authors.initials: S
authors.lastname: Hanada
authors.affiliation: Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan;
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Eto
authors.affiliation: Department of Hematology, Sasebo City General Hospital, Sasebo, Japan;
authors.forename: Yukiyoshi
authors.initials: Y
authors.lastname: Moriuchi
authors.affiliation: Department of Hematology, Oita Prefectural Hospital, Oita, Japan;
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Saburi
authors.affiliation: Department of Internal Medicine, Karatsu Red Cross Hospital, Karatsu, Japan;
authors.forename: Masaharu
authors.initials: M
authors.lastname: Miyahara
authors.affiliation: Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan;
authors.forename: Eisaburo
authors.initials: E
authors.lastname: Sueoka
authors.affiliation: Department of Hematology, National Kyushu Cancer Center, Fukuoka, Japan;
authors.forename: Naokuni
authors.initials: N
authors.lastname: Uike
authors.affiliation: Department of Hematology, National Hospital Organization Nagasaki Medical Center, Omura, Japan;
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Yoshida
authors.affiliation: Department of Internal Medicine, Miyazaki Prefectural Hospital, Miyazaki, Japan;
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Yamashita
authors.affiliation: Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan;
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Tsukasaki
authors.affiliation: Department of Hematology, Kumamoto Shinto General Hospital, Kumamoto, Japan;
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Suzushima
authors.affiliation: Department of Internal Medicine, Kitakyushu Municipal Medical Center, Kitakyushu, Japan;
authors.forename: Yuju
authors.initials: Y
authors.lastname: Ohno
authors.affiliation: Department of Internal Medicine, Koga General Hospital, Miyazaki, Japan;
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Matsuoka
authors.affiliation: Department of Hematology, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan;
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Jo
authors.affiliation: Department of Dermatology, Miyazaki University, Miyazaki, Japan;
authors.forename: Masahiro
authors.initials: M
authors.lastname: Amano
authors.affiliation: Department of Dermatology, University of Occupational and Environmental Health, Kitakyushu, Japan;
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Hino
authors.affiliation: Clinical Research Institute, National Kyushu Cancer Center, Fukuoka, Japan;
authors.forename: Mototsugu
authors.initials: M
authors.lastname: Shimokawa
authors.affiliation: Department of Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan; and.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kawai
authors.affiliation: Cancer Center, Shimane University Hospital, Izumo, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Suzumiya
authors.affiliation: Division of Medical Oncology, Hematology and Infectious Diseases, Department of Medicine, School of Medicine, Fukuoka University, Fukuoka, Japan;
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tamura
mesh_terms: D000368:Aged; D064591:Allografts; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D019468:Disease Management; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000706:statistics & numerical data*; D006801:Humans; D007239:Infections / Q000401:mortality; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000145:classification / Q000188:drug therapy / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents