Major prognostic factors of Japanese patients with lymphoma‐type adult T‐cell leukemia

Shimamoto, Yoshinori; Suga, Kenji; Nishimura, Junji; Nawata, Hajime; Yamaguchi, M.

doi:10.1002/ajh.2830350403

Cited by 14 publications

(7 citation statements)

References 22 publications

(6 reference statements)

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“…Prognostic factors significant at peO.05 in the stepwise Cox proportional hazard analysis were defined as those influencing survival. Statistical analysis was performed using the SD-BASE I1 programs from the MPC statistical pack-age (Tokyo, Japan) and a NEC PC-9801 V X microcomputer, as described previously (13). To illustrate the effects on survival of variables obtained in the multivariate analysis, the hazard ratio was calculated for each group by the following formula:…”

Section: Methodsmentioning

confidence: 99%

A new risk grouping for IgD myeloma based on analysis of 165 Japanese patients

Shimamoto

Anami

Yamaguchi

1991

European J of Haematology

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The common staging systems for myeloma do not include IgD myeloma because its rarity makes analysis difficult. We studied a series of 165 Japanese patients with IgD myeloma retrospectively to assess which of the easily assessable parameters present at the time of diagnosis were of prognostic significance. The important individual variables detected in a previous univariate analysis were placed in a multiple regression model to identify the major prognostic factors for survival. This analysis showed that light‐chain subtype and white blood cell (WBC) count had a strong predictive relationship for the length of survival. These two factors were used to construct a model containing four categories of patients at increased risk for shortened survival. These categories divided the patients into three groups with respective 5‐year survival rates of 66% (low risk), 23% (moderate risk), and 0% (high risk). This new risk grouping showed prognostic validity for IgD myeloma.

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Section: Methodsmentioning

confidence: 99%

A new risk grouping for IgD myeloma based on analysis of 165 Japanese patients

Shimamoto

Anami

Yamaguchi

1991

European J of Haematology

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“…Adult T‐cell leukaemia lymphoma (ATLL) is an aggressive T‐cell malignancy aetiologically linked to the human T‐lymphotropic virus 1 (HTLV‐I) with median survival ranging from 7 to 13 months in both endemic and non‐endemic regions (Shimamoto et al , 1990a, b; Shimoyama et al , 1991; Plumelle et al , 1993; Pombo de Oliveira et al , 1995; Matutes & Catovsky, 1998). In the United Kingdom (UK), the disease affects mainly immigrants from the Caribbean basin or Africa and more rarely from other countries (Matutes & Catovsky, 1994).…”

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confidence: 99%

Interferon α and zidovudine therapy in adult T‐cell leukaemia lymphoma: response and outcome in 15 patients

Matutes

Taylor²,

Cavenagh

et al. 2001

Br J Haematol

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Adult T‐cell leukaemia lymphoma (ATLL) is an aggressive disease caused by the human T‐lymphotropic virus 1 (HTLV‐I) with a short survival. Responses to interferon alpha (IFN‐α) and zidovudine (AZT) have been documented but not with long‐term follow‐up. We treated 15 ATLL patients with IFN and AZT. Eleven patients had acute ATLL, two had lymphoma and two smouldering ATLL, with progression. The main features were: organomegaly (14), skin lesions (10), high white blood cell (WBC) count (11) and hypercalcaemia (9). Eleven patients had previously received chemotherapy and one had received an autograft. At the time of the study, seven patients had progressive disease and eight were in partial or complete clinical remission. Responses (PR) lasting 2+ to 44+ months were seen in 67%; 26% did not respond (NR) and one patient was not evaluable. Hypercalcaemia predicted a poor outcome but differences were not significant. Eight of the 15 patients have died 3–41 months from diagnosis. Median survival for the 15 patients was 18 months. Survival of the NR ranged from 4 to 20 months; six PR patients are alive 8–82 months from diagnosis. The differences in survival between NR (median: 6 months) and PR (55% of patients alive at 4 years) were statistically significant (P = 0·002). In conclusion, IFN and AZT improves the outcome of ATLL patients and helps maintain responses.

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“…Adult T‐cell leukaemia/lymphoma (ATLL) is a malignant T‐cell disorder caused by HTLV‐1 (Poiesz et al , 1980; Yoshida et al , 1982). About 30–50% of patients treated for ATLL achieve complete remission after combination chemotherapy or treatment by zidovudine and interferon‐alpha (Shimamoto et al , 1990; Gill et al , 1995; Hermine et al , 1995). Many of these patients relapse and the overall survival remains short (Shimamoto et al , 1990).…”

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confidence: 99%

“…About 30–50% of patients treated for ATLL achieve complete remission after combination chemotherapy or treatment by zidovudine and interferon‐alpha (Shimamoto et al , 1990; Gill et al , 1995; Hermine et al , 1995). Many of these patients relapse and the overall survival remains short (Shimamoto et al , 1990). However, long‐term disease‐free survival can be obtained after consolidation by allogeneic bone marrow transplantation (BMT) (Borg et al , 1996; Sobue et al , 1987).…”

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Semiquantitative analysis of residual disease in patients treated for adult T‐cell leukaemia/lymphoma (ATLL)

et al. 1999

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Summary. Many adult T-cell leukaemia/lymphoma (ATLL)patients who respond to induction treatment, then relapse. Knowing the clonality pattern of residual tumourous clones during treatment could help understand disease evolution and aid therapeutic decisions. We developed a sensitive and semi-quantitative molecular analysis of these clones in ATLL patients. DNA samples from PBMCs derived from eight ATLL patients were studied over time by quadruplicate linker mediated PCR (LMPCR) amplification of HTLV-1 integration sites. Patients were treated with combination chemotherapy, zidovudine-interferon-alpha and/or by peripheral stem cell transplantation or allogeneic bone marrow transplantation. Persistence of tumourous clones at a high frequency (>1/ 300 PBMCs) was frequently observed, even in complete responders, and was invariably correlated with relapse and/ or poor outcome. Fluctuation in the frequency of some tumourous clones was observed with evidence for clonal change under treatment in one patient, indicating that treatment of ATLL can result in the selection of resistant clones. Finally, allogeneic bone marrow transplantation (BMT) using an HTLV-1 infected sibling as donor was found to be associated with long-lasting disappearance of tumourous clones and a possible cure of the disease. Longterm persistent clonal expansion of circulating HTLV-1 bearing T cells which derived from the donor bone marrow was evidenced in this patient. In conclusion, variable success in treatment of ATLL is probably due to the clonal heterogeneity which results in the selection of resistant clones. Semi-quantitative assessment of residual disease (RD) through LMPCR may predict treatment failure. Accordingly, additional therapy may be tailored to the clonality pattern observed after first-line therapy.

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Major prognostic factors of Japanese patients with lymphoma‐type adult T‐cell leukemia

Cited by 14 publications

References 22 publications

A new risk grouping for IgD myeloma based on analysis of 165 Japanese patients

A new risk grouping for IgD myeloma based on analysis of 165 Japanese patients

Interferon α and zidovudine therapy in adult T‐cell leukaemia lymphoma: response and outcome in 15 patients

Semiquantitative analysis of residual disease in patients treated for adult T‐cell leukaemia/lymphoma (ATLL)

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