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Integrated genetic and clinical prognostic factors for aggressive adult T-cell leukemia/lymphoma
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- Kameda, Takuro
- Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki
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- Kataoka, Keisuke
- Division of Hematology, Department of Medicine, Keio University School of Medicine; Division of Molecular Oncology, National Cancer Center Research Institute
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- Kamiunten, Ayako
- Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki
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- Hidaka, Michihiro
- National Hospital Organization Kumamoto Medical Center
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- Miyoshi, Hiroaki
- Department of Pathology, Kurume University School of Medicine
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- Nakano, Nobuaki
- Department of Hematology, Imamura General Hospital
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- Nosaka, Kisato
- Department of Hematology, Rheumatology and Infectious Diseases, Faculty of Life Sciences, Kumamoto University of Medicine
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- Yoshimitsu, Makoto
- Department of Hematology and Rheumatology, Kagoshima University Hospital
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- Yasunaga, Jun-Ichirou
- Department of Hematology, Rheumatology and Infectious Diseases, Faculty of Life Sciences, Kumamoto University of Medicine; Institute for Frontier Life and Medical Sciences, Kyoto University
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- Kogure, Yasunori
- Division of Molecular Oncology, National Cancer Center Research Institute
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- Shide, Kotaro
- Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki
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- Miyahara, Masaharu
- Department of Internal Medicine, Karatsu Red Cross Hospital
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- Sakamoto, Takashi
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University
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- Akizuki, Keiichi
- Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki
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- Hidaka, Tomonori
- Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki
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- Kubuki, Yoko
- Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki
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- Koya, Junji
- Division of Molecular Oncology, National Cancer Center Research Institute
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- Kawano, Noriaki
- Department of Internal medicine, Miyazaki Prefectural Miyazaki Hospital
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- Yamashita, Kiyoshi
- Department of Internal medicine, Miyazaki Prefectural Miyazaki Hospital
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- Kawano, Hiroshi
- Department of Internal medicine, Koga General Hospital
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- Toyama, Takanori
- Department of Internal medicine, Miyazaki Prefectural Nobeoka Hospital
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- Maeda, Kouichi
- National Hospital Organization Miyakonojo Medical center
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- Marutsuka, Kosuke
- Department of Anatomic Pathology, Miyazaki Prefectural Miyazaki Hospital
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- Imaizumi, Yoshitaka
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University
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- Kato, Koji
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences
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- Sugio, Takeshi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences
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- Tokunaga, Masahito
- Department of Hematology, Imamura General Hospital
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- Tashiro, Yukie
- Department of Pathology, Imamura General Hospital
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- Takaori-Kondo, Akifumi
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University
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- Miyazaki, Yasushi
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University
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- Akashi, Koichi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences
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- Ishitsuka, Kenji
- Department of Hematology and Rheumatology, Kagoshima University Hospital
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- Matsuoka, Masao
- Department of Hematology, Rheumatology and Infectious Diseases, Faculty of Life Sciences, Kumamoto University of Medicine
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- Ohshima, Koichi
- Department of Pathology, Kurume University School of Medicine
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- Watanabe, Toshiki
- Department of Practical Management of Medical Information, St Marianna University, Graduate School of Medicine
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- Kitanaka, Akira
- Department of Laboratory Medicine, Kawasaki Medical School
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- Utsunomiya, Atae
- Department of Hematology, Imamura General Hospital
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- Ogawa, Seishi
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University
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- Shimoda, Kazuya
- Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki
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Description
The prognosis of aggressive adult T-cell leukemia/lymphoma (ATL) is poor, and allogeneic hematopoietic stem-cell transplantation (allo-HSCT) is a curative treatment. To identify favorable prognostic patients after intensive chemotherapy, and who therefore might not require upfront allo-HSCT, we aimed to improve risk stratification of aggressive ATL patients aged <70 years. The clinical risk factors and genetic mutations were incorporated into risk modeling for overall survival (OS). We generated the m7-ATLPI, a clinicogenetic risk model for OS, that included the ATL prognostic index (PI) (ATL-PI) risk category, and non-silent mutations in seven genes, namely TP53, IRF4, RHOA, PRKCB, CARD11, CCR7, and GATA3. In the training cohort of 99 patients, the m7-ATLPI identified a low-, intermediate-, and high-risk group with 2-year OS of 100%, 43%, and 19%, respectively (hazard ratio [HR] 5.46, p < 0.0001). The m7-ATLPI achieved superior risk stratification compared to the current ATL-PI (C-index 0.92 vs. 0.85, respectively). In the validation cohort of 84 patients, the m7-ATLPI defined low-, intermediate-, and high-risk groups with a 2-year OS of 81%, 30%, and 0%, respectively (HR 2.33, p = 0.0094), and the model again outperformed the ATL-PI (C-index 0.72 vs. 0.70, respectively). The simplified m7-ATLPI, which is easier to use in clinical practice, achieved superior risk stratification compared to the ATL-PI, as did the original m7-ATLPI; the simplified version was calculated by summing the following: high-risk ATL-PI category (+10), low-risk ATL-PI category (−4), and non-silent mutations in TP53 (+4), IRF4 (+3), RHOA (+1), PRKCB (+1), CARD11 (+0.5), CCR7 (−2), and GATA3 (−3).
Journal
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- Haematologica
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Haematologica 108 (8), 2178-2191, 2023-08
Ferrata Storti Foundation (Haematologica)
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Keywords
Details 詳細情報について
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- CRID
- 1050859989804918656
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- ISSN
- 15928721
- 03906078
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- HANDLE
- 2433/284568
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- PubMed
- 36794502
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- Text Lang
- en
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- Article Type
- journal article
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- Data Source
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- IRDB
- Crossref
- KAKEN
- OpenAIRE