Treatment of aggressive adult T-cell leukemia/lymphoma: a retrospective study in a hospital located in HTLV-1 highly endemic area.
Treatment of aggressive adult T-cell leukemia/lymphoma: a retrospective study in a hospital located in HTLV-1 highly endemic area.
复制标题
侵袭性成人 T 细胞白血病/淋巴瘤的治疗：HTLV-1 高流行区一家医院的回顾性研究。
DOI：
10.1007/s12185-019-02769-w
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Ishitsuka K.
中科院分区：
文献类型：
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作者：
Nakamura D;Yoshimitsu M;Tabuchi T;Arima N;Hayashida M;Inoue H;Matsushita K;Matsumoto T;Arima N;Ishitsuka K.
成人T细胞白血病/淋巴瘤（ATL）是一种与人类T细胞白血病病毒I型（HTLV-1）相关的外周T细胞肿瘤;预后仍然非常差。我们回顾性分析了2005年至2014年在日本HTLV-1高度流行地区的一家医院诊断的198例急性、淋巴瘤和不利慢性型ATL（侵袭性ATL）患者的治疗。分别有143例和35例患者接受了OPEC/MPEC和VCAP-AMP-VECP治疗。直到2010年左右，主要使用OPEC/MPEC，逐渐改用VCAP-AMP-VECP，尤其是年轻患者。VCAP-AMP-VECP治疗患者的2年总生存率显著高于< 70岁患者使用OPEC/MPEC的2年总生存率（y.o.），但不适用于≥ 70岁的患者。即使在老年患者中，也可以在不降低剂量强度的情况下进行强度较低的化疗OPEC/MPEC，其治疗结果不劣于VCAP-AMP-VECP。很难从这项小型回顾性研究中得出明确的结论;然而，OPEC/MPEC可能是侵袭性ATL老年患者的替代选择。
Adult T-cell leukemia/lymphoma (ATL) is a peripheral T-cell neoplasm associated with the human T-cell leukemia virus type-I (HTLV-1); prognosis still remains very poor. We retrospectively reviewed the treatment of 198 patients with acute-, lymphoma- and unfavorable chronic-type ATL (aggressive ATL) diagnosed from 2005 to 2014 in a hospital located in an area of Japan in which HTLV-1 is highly endemic. One-hundred forty-three, and 35 patients were treated using OPEC/MPEC and VCAP-AMP-VECP, respectively. OPEC/MPEC was mainly used until around 2010, and gradually switched to VCAP-AMP-VECP, especially for younger patients. The 2-year overall survival for patients treated by VCAP-AMP-VECP was significantly higher than that using OPEC/MPEC for patients < 70 years old (y.o.), but not for patients ≥ 70 y.o. A less intensive chemotherapy OPEC/MPEC could be performed without reducing dose intensity, even in elderly patients, and its therapeutic outcome is not inferior to that of VCAP-AMP-VECP. It is difficult to draw definite conclusion from this small retrospective study; however, OPEC/MPEC may represent an alternative option for elderly patients with aggressive ATL.