Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan.
Department of Internal Medicine, Koga General Hospital, Miyazaki 880-0041, Japan.
Viruses. 2022 Mar 29;14(4):710. doi: 10.3390/v14040710.
A retrospective chart survey of the clinical features of indolent adult T-cell leukemia/lymphoma (ATL) was conducted in the Miyazaki Prefecture, Japan. This study enrolled 24 smoldering-type ATLs, 10 favorable chronic-type ATLs, and 20 unfavorable chronic-type ATLs diagnosed between 2010 and 2018. Among them, 4, 3, and 10 progressed to acute-type ATLs during their clinical course. The median survival time (MST) in smoldering-type ATL and favorable chronic-type ATL was not reached, and their 4-year overall survival (OS) was 73% and 79%, respectively. Compared with this, the prognosis of unfavorable chronic-type ATL was poor. Its MST was 3.32 years, and the 4-year OS was 46% (p = 0.0095). In addition to the three features that determine the unfavorable characteristics of chronic-type ATL, namely, increased lactate dehydrogenase, increased blood urea nitrogen, and decreased albumin, the high-risk category by the indolent ATL-Prognostic Index, which was defined by an increment of soluble interleukin-2 receptor (sIL2-R) of >6000 U/mL, could explain the poor prognosis in indolent ATL patients. The level of sIL-2R might be an indicator of the initiation of therapy for indolent ATL.
对日本宫崎县惰性成人 T 细胞白血病/淋巴瘤（ATL）的临床特征进行了回顾性图表调查。该研究纳入了 2010 年至 2018 年间诊断的 24 例冒烟型 ATL、10 例有利型慢性型 ATL 和 20 例不利型慢性型 ATL。其中，4 例、3 例和 10 例在临床过程中进展为急性型 ATL。冒烟型 ATL 和有利型慢性型 ATL 的中位生存时间（MST）未达到，其 4 年总生存率（OS）分别为 73%和 79%。相比之下，不利型慢性型 ATL 的预后较差。其 MST 为 3.32 年，4 年 OS 为 46%（p = 0.0095）。除了确定慢性型 ATL 不良特征的三个特征（乳酸脱氢酶升高、血尿素氮升高和白蛋白降低）外，由可溶性白细胞介素 2 受体（sIL2-R）增加>6000 U/mL 定义的惰性 ATL 预后指数的高危类别也可以解释惰性 ATL 患者的不良预后。sIL-2R 水平可能是开始惰性 ATL 治疗的指标。
