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Characterization of patients with aggressive adult T-cell leukemia–lymphoma in Okinawa, Japan: a retrospective analysis of a large cohort

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Abstract

Okinawa Prefecture, located in the subtropics, is an area of endemic adult T-cell leukemia–lymphoma (ATL) in Japan. We retrospectively analyzed 659 patients with aggressive ATL in seven institutions in Okinawa between 2002 and 2011. The median patient age was 68 years. More patients were aged ≥90 years (2.6 %), in this study, than in a nationwide survey (<1 %). The median survival time (MST) of the entire cohort was 6.5 months. Of the 217 patients who had a clinical status similar to that stated in the eligibility criteria of JCOG9801 (a randomized phase III study comparing VCAP-AMP-VECP with CHOP-14), 147 who received the CHOP regimen had a poorer MST than those in the CHOP-14 arm of JCOG9801 (8 vs 11 months). The prevalence of strongyloidiasis in the ATL patients was much higher (12.4 %) than in the historical cohort who visited the University of the Ryukyus Hospital (3.4 %). Furthermore, strongyloidiasis may be associated with ATL-related deaths. These findings suggest that, compared with other areas in Japan, in Okinawa, the proportion of patients aged ≥90 years with clinical features of aggressive ATL is higher, outcomes are poorer, and the disease is associated with a higher prevalence of strongyloidiasis.

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Acknowledgments

This work was supported by a grant from Okinawa Prefecture, Japan (grant to T.F. and T.T.).

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Authors and Affiliations

  1. Division of Endocrinology, Diabetes and Metabolism, Hematology (Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, Nishihara, Japan

    Yukiko Nishi, Takeaki Tomoyose, Sawako Nakachi, Kazuho Morichika, Iori Tedokon, Keita Tamaki, Natsuki Shimabukuro & Hiroaki Masuzaki

  2. Laboratory of Hematoimmunology, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan

    Takuya Fukushima & Megumi Kuba-Miyara

  3. Biostatistics Division, Center for Research and Administration and Support, National Cancer Center, Tokyo, Japan

    Shogo Nomura

  4. Department of Hematology, Heartlife Hospital, Nakagusuku, Japan

    Naoya Taira, Takashi Miyagi, Kaori Karimata, Masayo Ohama & Atsushi Yamanoha

  5. Department of Hematology, Okinawa Prefectural Chubu Hospital, Uruma, Japan

    Kazumitsu Tamaki

  6. Department of Hematology, Nakagami Hospital, Okinawa, Japan

    Masaki Hayashi

  7. Department of Hematology, Naha City Hospital, Naha, Japan

    Hitoshi Arakaki & Jun-Nosuke Uchihara

  8. Department of Hematology, Okinawa Prefectural Nambu Medical Center and Children’s Medical Center, Haebaru, Japan

    Kazuiku Ohshiro

  9. Department of Hematology, Okinawa Red Cross Hospital, Naha, Japan

    Yoshitaka Asakura

  10. Department of Pathology and Cell Biology, Graduate School of Medicine, University of the Ryukyus, Nishihara, Japan

    Kennosuke Karube

Authors
  1. Yukiko Nishi
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  2. Takuya Fukushima
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  3. Shogo Nomura
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  4. Takeaki Tomoyose
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  6. Kazuho Morichika
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  8. Keita Tamaki
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  11. Takashi Miyagi
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  15. Kazumitsu Tamaki
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  16. Masaki Hayashi
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  17. Hitoshi Arakaki
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  18. Jun-Nosuke Uchihara
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  20. Yoshitaka Asakura
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  21. Megumi Kuba-Miyara
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  23. Hiroaki Masuzaki
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Correspondence to Takuya Fukushima.

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Nishi, Y., Fukushima, T., Nomura, S. et al. Characterization of patients with aggressive adult T-cell leukemia–lymphoma in Okinawa, Japan: a retrospective analysis of a large cohort. Int J Hematol 104, 468–475 (2016). https://doi.org/10.1007/s12185-016-2042-y

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  • DOI: https://doi.org/10.1007/s12185-016-2042-y

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