The clinical impact of the ratio of C-reactive protein to albumin (CAR) in patients with acute- and lymphoma-type adult T-cell leukemia-lymphoma (ATL)
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- Kawano Noriaki
- Department of Internal Medicine/Hematology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan,
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- Shimonodan Hidemi
- Department of Pediatrics, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan,
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- Nagahiro Yuri
- Department of Psychiatry, Jozan Hospital, Kumamoto, Japan,
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- Yoshida Shuro
- Department of Internal Medicine/Hematology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan,
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- Kuriyama Takuro
- Department of Internal Medicine/Hematology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan,
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- Takigawa Ken
- Department of Internal Medicine/Hematology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan,
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- Tochigi Taro
- Department of Internal Medicine/Hematology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan,
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- Nakaike Takashi
- Department of Internal Medicine/Hematology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan,
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- Makino Shigeyoshi
- Department of Internal Medicine/Hematology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan,
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- Yamashita Kiyoshi
- Department of Internal Medicine/Hematology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan,
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- Marutsuka Kousuke
- Department of Pathology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan,
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- Ochiai Hidenobu
- Trauma and Critical Care Center, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan,
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- Mori Yasuo
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan,
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- Shimoda Kazuya
- Division of Gastroenterology and Hematology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan,
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- Ohshima Kouichi
- Department of Pathology, Kurume University, Fukuoka, Japan
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- Mashiba Koichi
- Department of Internal Medicine/Hematology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan,
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- Kikuchi Ikuo
- Department of Internal Medicine/Hematology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan,
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Description
<p>Recently, the ratio of C-reactive protein to albumin (CAR) is used as an inflammatory marker that has been demonstrated to be a simple and reliable prognostic factor in solid tumors and hematological malignancy. However, no studies of the CAR have been performed in patients with adult T-cell leukemia-lymphoma (ATL). We retrospectively analyzed the clinical features and outcomes in 68 newly diagnosed acute- and lymphoma-type ATL [(acute-(n=42) or lymphoma-type (n=26)] patients in Miyazaki Prefecture from 2013 to 2017. Furthermore, we investigated correlations between pretreatment CAR levels and clinical features. The median age was 67 years (range, 44 - 87). Patients were initially treated by either palliative therapy (n=14) or chemotherapy [n=54; CHOP therapy (n=37)/ VCAP-AMP-VECP therapy (n=17)], and showed median survival durations of 0.5 months and 7.4 months, respectively. The factors affecting OS by multivariate analysis were age, BUN, and CAR. Importantly, we revealed that the high CAR group (optimal cut-off point; 0.553) was a significant indicator of worse OS by multivariate analysis (p< 0.001, HR; 5.46). The median survival of patients with a CAR< 0.553 was 8.37 months, while patients with a CAR>0.553 had a median survival of 3.94 months. The different clinical features between high CAR and low CAR groups were hypoproteinemia and the implementation of chemotherapy. Furthermore, in the chemotherapy group, but not the palliative therapy group, CAR was a significant prognostic marker. Our study indicated that CAR may be a new simple and significant independent prognostic marker in acute- and lymphoma-type ATL patients.</p>
Journal
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- Journal of Clinical and Experimental Hematopathology
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Journal of Clinical and Experimental Hematopathology 63 (2), 73-82, 2023
The Japanese Society for Lymphoreticular Tissue Research