Division of Medical Oncology, Department of Medicine, Columbia University College of Physicians and Surgeons, Milstein Hospital Building, New York, New York 10032, USA.
Cancer. 2010 Jul 15;116(14):3438-46. doi: 10.1002/cncr.25147.
To define the clinicopathologic and prognostic features of patients with human T-cell lymphotropic virus type-1 (HTLV-1)-associated adult T-cell leukemia/lymphoma (ATLL) in North America, standard criteria were used to identify patients with ATLL.
Statistical analyses used included descriptive statistics, Kaplan-Meir survival analysis, and recursive partitioning.
Eighty-nine patients were identified between August 1992 and May 2007, including 37 (41.6%) males and 52 (58.4%) females with a median age of 50 years (range, 22-82 years). All but 6 patients had immigrated to the United States from the Caribbean, Latin America, or Africa. The acute subtype predominated (68.5%). The majority of patients received a combination-alkylator-based chemotherapy regimen in the front-line setting (72.6%). The most common regimen was cyclophosphamide, doxorubicin, vincristine, and prednisone at standard doses or attenuated and/or with methotrexate (CHOP-like), which produced an overall response rate of 64.1%. Despite initial responses to therapy, the median overall survival for all subtypes was 24 weeks (range, 0.9-315 weeks). Although the International Prognostic Index and Prognostic Index for peripheral T-cell lymphoma unspecified identified subsets of patients, these models were not completely predictive. A recursive partitioning analysis was performed on the data, which successfully identified 3 prognostic categories based on Eastern Cooperative Oncology Group performance status, stage, age, and calcium level at diagnosis.
This series proposed a new prognostic model for patients with HTLV-1-associated ATLL and confirmed a poor outcome for these patients in North America.
为了定义北美人种 T 细胞嗜淋巴细胞病毒 1 型（HTLV-1）相关成人 T 细胞白血病/淋巴瘤（ATLL）患者的临床病理和预后特征，使用标准标准来识别 ATLL 患者。
使用的统计分析包括描述性统计、Kaplan-Meier 生存分析和递归分区。
1992 年 8 月至 2007 年 5 月期间共确定了 89 例患者，其中男性 37 例（41.6%），女性 52 例（58.4%），中位年龄为 50 岁（范围，22-82 岁）。除 6 例患者外，所有患者均从加勒比海、拉丁美洲或非洲移民到美国。急性亚型为主（68.5%）。大多数患者在前一线接受了联合烷化剂为基础的化疗方案（72.6%）。最常见的方案是标准剂量或减毒的环磷酰胺、多柔比星、长春新碱和泼尼松（CHOP 样），总缓解率为 64.1%。尽管对治疗有初步反应，但所有亚型的中位总生存期均为 24 周（范围，0.9-315 周）。尽管国际预后指数和未特指外周 T 细胞淋巴瘤的预后指数确定了患者的亚组，但这些模型并不完全具有预测性。对数据进行了递归分区分析，成功地根据东部合作肿瘤学组的表现状态、分期、年龄和诊断时的钙水平确定了 3 个预后类别。
本系列提出了一种新的 HTLV-1 相关 ATLL 患者的预后模型，并证实了北美患者的预后不良。
