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. 2021 Mar;106(3):398-407.
doi: 10.1111/ejh.13565. Epub 2020 Dec 19.

Higher average chemotherapy dose intensity improves prognosis in patients with aggressive adult T-cell leukemia/lymphoma

Masaaki Sekine  1 , Takuro Kameda  1 , Kotaro Shide  1 , Kouichi Maeda  2 , Takanori Toyama  3 , Noriaki Kawano  4 , Masanori Takeuchi  5 , Hiroshi Kawano  5 , Seiichi Sato  2 , Junzo Ishizaki  6 , Toshimasa Kukita  7 , Ayako Kamiunten  1 , Keiichi Akizuki  1 , Yuki Tahira  1 , Haruko Shimoda  1 , Tomonori Hidaka  1 , Kiyoshi Yamashita  4 , Hitoshi Matsuoka  5 , Akira Kitanaka  8 , Yoko Kubuki  1 , Kazuya Shimoda  1
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Higher average chemotherapy dose intensity improves prognosis in patients with aggressive adult T-cell leukemia/lymphoma

Masaaki Sekine et al. Eur J Haematol. 2021 Mar.

Abstract

Objective and method: Adult T-cell leukemia/lymphoma (ATL) is an aggressive peripheral T-cell lymphoma with poor prognosis. We retrospectively reviewed the medical records of 312 patients with aggressive ATL and analyzed the effect of chemotherapy dose intensity on prognosis in clinical practice.

Result: As first-line therapy, 62 patients underwent best supportive care (BSC) or single-agent chemotherapy, and 235 underwent intensive chemotherapy. The median survival time (MST) was 0.58 years in the 312 total patients, and 0.13 years and 0.75 years in the BSC/single-agent chemotherapy group and intensive chemotherapy group, respectively. The median average relative dose intensity (ARDI) of patients who received intensive chemotherapy was 60%. We divided patients into 3 groups according to ARDI. Those in the top tertile of ARDI (ARDI ≥ 75%, n = 82) had better overall survival compared with those in the intermediate tertile (45% ≤ ARDI < 75%, n = 79) (P < .0001), with MSTs of 4.69 and 0.75 years, respectively. The occurrence of organ dysfunction and infectious complications was comparable between the two ARDI groups.

Conclusion: Higher ARDI improves prognosis in patients with aggressive ATL in clinical practice.

Keywords: ATL; chemotherapy; dose intensity; outcomes research.

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References

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