Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Mar;108(3):212-222.
doi: 10.1111/ejh.13728. Epub 2021 Dec 8.

Systematic review of survival outcomes for relapsed or refractory adult T-cell leukemia-lymphoma

Kisato Nosaka  1 , Bruce Crawford  2 , Jingbo Yi  2 , William Kuan  2 , Tomoko Matsumoto  2 , Takeshi Takahashi  3
Affiliations

Systematic review of survival outcomes for relapsed or refractory adult T-cell leukemia-lymphoma

Kisato Nosaka et al. Eur J Haematol. 2022 Mar.

Abstract

Introduction: Adult T-cell leukemia-lymphoma (ATL) is a mature T-cell lymphoproliferative neoplasm caused by human T-cell leukemia virus type-1 infection. There is no standard treatment for relapsed or refractory (r/r) ATL, and clinical outcomes are poor. This systematic review examined the survival outcomes for r/r ATL treated with various systemic therapies.

Methods: EMBASE and PubMed were searched for studies on r/r ATL, published between January 2010 and January 2020. The main outcome of interest was overall survival (OS). Median OS and an exploratory 30% OS time were assessed based on published data and Kaplan-Meier curves.

Results: There were 21 unique treatment subgroups (from 14 studies), that met the eligibility criteria. Nine subgroups were mogamulizumab treatment, two were mogamulizumab prior to allogenic hematopoietic stem cell transplantation (allo-HSCT), five were allo-HSCT, and five were other chemotherapy. Respectively, the median OS and 30% OS varied considerably in range for mogamulizumab treatment (2.2-17.6 months and 8.7-27.1 months), allo-HSCT (3.8-6.2 months and 7.5-19.8 months), and other chemotherapy arms (4.1-20.3 months and 7.1-17.0 months).

Conclusion: Mogamulizumab was the most frequently studied treatment regimen and can potentially provide longer survival compared with chemotherapy alone. Future comparisons with synthetic or historical control arms may enable clearer insights into treatment efficacy.

Keywords: adult T-cell leukemia-lymphoma; drug therapy; hematopoietic stem cell transplantation; recurrence; survival; systematic review.

PubMed Disclaimer

Conflict of interest statement

KN has received honoraria from Kyowa Kirin, Chugai Pharma, Novartis, Celgene, Eisai, Merck Sharp & Dohme, and Bristol‐Myers Squibb and consultant fees from Kyowa Kirin; TT is a full‐time employee of Kyowa Kirin Co., Ltd; BC, JY, WK, and TM were employees of Syneos Health at the time of this study and have no conflict of interest to declare.

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram
FIGURE 2
FIGURE 2
Median overall survival of r/r ATL patients by treatment arm. *Studies that reported overall survival from diagnosis; †studies that reported overall survival from relapse; ‡studies did not report the timing of overall survival initiation; studies without those markings reported overall survival from the treatment initiation. §Studies reported without mogamulizumab. # Studies from which KM curves were reconstructed to calculate 95% CI; and ¶studies from which KM curves were reconstructed to calculate median OS and 95% CI
FIGURE 3
FIGURE 3
Exploratory 30% overall survival of r/r ATL patients by treatment arm (estimated from reconstructed KM curves). * Studies that reported overall survival from diagnosis; †studies that reported overall survival from relapse; ‡studies did not report the timing of overall survival initiation; studies without those markings reported overall survival from the treatment initiation; and §studies reported without mogamulizumab
See this image and copyright information in PMC

References

    1. Yoshida M, Miyoshi I, Hinuma Y. Isolation and characterization of retrovirus from cell lines of human adult T‐cell leukemia and its implication in the disease. Proc Natl Acad Sci. 1982;79(6):2031‐2035. 10.1073/pnas.79.6.2031 - DOI - PMC - PubMed
    1. Poiesz BJ, Ruscetti FW, Gazdar AF, Bunn PA, Minna JD, Gallo RC. Detection and isolation of type C retrovirus particles from fresh and cultured lymphocytes of a patient with cutaneous T‐cell lymphoma. Proc Natl Acad Sci U S A. 1980;77(12):7415‐7419. 10.1073/pnas.77.12.7415 - DOI - PMC - PubMed
    1. Takatsuki K, Uchiyama J, Sagawa K, Yodoi J. Adult T‐cell leukemia in Japan. In: Seno S, Takaku F, Irino S, editors. Topics in Hematology. Exerpta Medica; 1977. pp. 73‐77.
    1. Uchiyama T, Yodoi J, Sagawa K, Takatsuki K, Uchino H. Adult T‐cell leukemia: clinical and hematologic features of 16 cases. Blood. 1977;50(3):481‐492. - PubMed
    1. Nosaka K, Iwanaga M, Imaizumi Y, et al. Epidemiological and clinical features of adult T‐cell leukemia–lymphoma in Japan, 2010–2011: A nationwide survey. Cancer Sci. 2017;108(12):2478‐2486. 10.1111/cas.13398 - DOI - PMC - PubMed

Publication types

Grants and funding