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Prognosis and Prognostic Index

Chapter

Abstract

Through clinical trials of intensive chemotherapy for patients with aggressive adult T-cell leukemia-lymphoma (ATL) (i.e., acute, lymphoma, or unfavorable chronic type), 5-year overall survival has improved from 5% in the 1980s to 15% in the 1990s. Comparatively, the median survival time (MST) of patients with indolent ATL (i.e., favorable chronic or smoldering) was 3–7 years with watchful waiting as the standard treatment. Recently, two types of prognostic indices (PIs) for aggressive ATL were published. A prognostic index for acute- and lymphoma-type ATL (ATL-PI) was reported in a retrospective analysis using the medical records of 807 patients in Japan. ATL-PI based on the Ann Arbor stage, Eastern Cooperative Oncology Group performance status, age, serum albumin, and soluble interleukin-2 receptor identified low-, intermediate-, and high-risk groups with MST of 16, 7, and 5 months, respectively. The Japan Clinical Oncology Group (JCOG)-PI was established by evaluating the clinical features of 276 patients with aggressive ATL in three consecutive JCOG trials. In multivariate analysis of 193 patients, the JCOG-PI based on corrected calcium levels and PS identified moderate- and high-risk groups with MST of 14 and 8 months, respectively. Both PIs are valuable for identifying patients with an extremely poor prognosis.

Keywords

Aggressive ATL Indolent ATL Prognostic index ATL-PI JCOG-PI 

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Copyright information

© Springer Japan KK 2017

Authors and Affiliations

  1. 1.Department of Clinical Laboratory Sciences, School of Health SciencesUniversity of the RyukyusOkinawaJapan

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