Real-World Data on Adult T-Cell Leukemia/Lymphoma in Latin America: A Study From the Grupo de Estudio Latinoamericano de Linfoproliferativos

被引：23

作者：

Malpica, Luis ^{[1
]}

Enriquez, Daniel J. ^{[2
]}

Castro, Denisse A. ^{[3
,4
]}

Pena, Camila ^{[5
]}

Idrobo, Henry ^{[6
]}

Fiad, Lorena ^{[7
]}

Prates, Maria ^{[7
]}

Otero, Victoria ^{[8
]}

Biglione, Mirna ^{[9
]}

Altamirano, Milagros ^{[10
]}

Sandival-Ampuero, Gustavo ^{[2
]}

Aviles-Perez, Ursula ^{[11
]}

Meza, Kelly ^{[12
]}

Aguirre-Martinez, Laura ^{[13
]}

Cristaldo, Nancy ^{[8
]}

Maradei, Juan L. ^{[14
]}

Guanchiale, Luciana ^{[15
]}

Soto, Pablo ^{[16
]}

Vinuela, Jose L. ^{[17
]}

Cabrera, Maria E. ^{[5
]}

Rose Paredes, Sally ^{[3
,4
]}

Riva, Eloisa ^{[18
]}

Di Stefano, Marcos ^{[19
]}

Noboa, Andrea ^{[20
]}

Choque, Juan A. ^{[21
]}

Candelaria, Myrna ^{[22
]}

Von Glasenapp, Alana ^{[23
]}

Valvert, Fabiola ^{[24
]}

Torres-Viera, Maria A. ^{[25
]}

Castillo, Jorge J. ^{[26
]}

Ramos, Juan Carlos ^{[27
]}

Villela, Luis ^{[28
]}

Beltran, Brady E. ^{[3
,4
]}

机构：

[1] Univ Texas MD Anderson Canc Ctr, Dept Lymphoma & Myeloma, Div Canc Med, Houston, TX 77030 USA

[2] Inst Nacl Enfermedades Neoplas, Dept Oncol Med, Lima, Peru

[3] Hosp Nacl Edgardo Rebagliati Martins, Dept Oncol & Radioterapia, Lima, Peru

[4] Univ San Martin Porres, Ctr Invest Med Precis, Lima, Peru

[5] Hosp Salvador, Hematol Sect, Santiago, Chile

[6] Hosp Univ Valle, Cali, Colombia

[7] Hosp Italiano La Plata, Hematol, La Plata, Argentina

[8] Hosp Italiano Buenos Aires, Secc Hematol, Buenos Aires, DF, Argentina

[9] Inst Invest Biomed Retrovirus & SIDA INBIRS UBA C, Buenos Aires, DF, Argentina

[10] Hosp Guillermo Almenara, Lima, Peru

[11] Univ Nacl Federico Villareal, Lima, Peru

[12] Weill Cornell Med, Dept Pediat, New York, NY USA

[13] Univ Valle, Fac Salud, Cali, Colombia

[14] Hosp Municipal Emilio Ferreyra, Serv Hematol, Necochea, Buenos Aires, Argentina

[15] Hosp Privado Univ Cordoba, Cordoba, Argentina

[16] Hosp Puerto Montt, Hematol Sect, Puerto Montt, Chile

[17] Hosp Dr Sotero del Rio, Hematol Sect, Santiago, Chile

[18] Hosp Clin Montevideo, Fac Med, Catedra Hematol, Montevideo, Uruguay

[19] Univ San Francisco Quito, Hosp Solca Quito, Hosp los Valles, Quito, Ecuador

[20] Inst Oncol Nacl Dr Juan Tanca Marengo, Serv Hematol, Guayaquil, Ecuador

[21] Hosp Especialidades Materno Infantil Caja Nacl Sa, La Paz, Bolivia

[22] Inst Nacl Cancerol, Res Div, Mexico City, DF, Mexico

[23] Inst Previs Social, Dept Hematol, Asuncion, Paraguay

[24] Inst Cancerol INCAN, Liga Nacl El Canc, Ciudad De Guatemala, Guatemala

[25] Univ Cent Venezuela, Caracas, Venezuela

[26] Dana Farber Canc Inst, Bing Ctr Waldenstrom Macroglobulinemia, Boston, MA USA

[27] Univ Miami, Miller Sch Med, Sylvester Comprehens Canc Ctr, Miami, FL 33136 USA

[28] Univ Valle Mexico, Hosp Fernando Ocaranza ISSSTE, Campus Hermosillo, Hermosillo, Sonora, Mexico

来源：

JCO GLOBAL ONCOLOGY | 2021年 / 7卷

关键词：

LYMPHOTROPIC VIRUS TYPE-1; PREVALENCE; LYMPHOMA; HTLV; RETROVIRUS; INFECTION; SURVIVAL; LEUKEMIA; MODEL;

D O I：

10.1200/GO.21.00084

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

PURPOSE Adult T-cell leukemia/lymphoma (ATLL) is an aggressive disease caused by the human T-cell leukemia virus type 1. Real-world data of ATLL in Latin America are lacking. PATIENTS AND METHODS We analyzed patients with ATLL (acute, lymphomatous, chronic, and smoldering) encountered in 11 Latin American countries between 1995 and 2019. Treatment response was assessed according to the 2009 consensus report. Survival curves were estimated using the Kaplan-Meier method and log-rank test. RESULTS We identified 253 patients; 226 (lymphomatous: n = 122, acute: n = 73, chronic: n = 26, and smoldering: n = 5) had sufficient data for analysis (median age 57 years). Most patients with ATLL were from Peru (63%), Chile (17%), Argentina (8%), and Colombia (7%). Hypercalcemia was positively associated with acute type (57% v lymphomatous 27%, P = .014). The median survival times (months) were 4.3, 7.9, 21.1, and not reached for acute, lymphomatous, chronic, and smoldering forms, with 4-year survival rates of 8%, 22%, 40%, and 80%, respectively. First-line zidovudine (AZT)-interferon alfa (IFN) resulted in an overall response rate of 63% (complete response [CR] 24%) for acute. First-line chemotherapy yielded an overall response rate of 41% (CR 29%) for lymphomatous. CR rate was 42% for etoposide, cyclophosphamide, vincristine, doxorubicin, and prednisone versus 12% for cyclophosphamide, vincristine, doxorubicin, and prednisone-like regimen (P < .001). Progression-free survival at 1 year for acute type patients treated with AZT-IFN was 67%, whereas 2-year progression-free survival in lymphomatous type patients who achieved CR after chemotherapy was 77%. CONCLUSION This study confirms Latin American ATLL presents at a younger age and has a high incidence of lymphomatous type, low incidence of indolent subtypes, and worse survival rates as compared with Japanese patients. In aggressive ATLL, chemotherapy remains the preferred choice for lymphomatous favoring etoposide-based regimen (etoposide, cyclophosphamide, vincristine, doxorubicin, and prednisone), whereas AZT-IFN remains a good first-line option for acute subtype. (C) 2021 by American Society of Clinical Oncology

引用

页码：1151 / 1166

页数：16

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