Combination of skin-directed therapy and oral etoposide for smoldering adult T-cell leukemia/lymphoma with skin involvement.

Abstract

Approximately 50% of patients with adult T-cell leukemia/lymphoma (ATLL) have skin involvement, and the smoldering, skin lesion-bearing cases are often treated with various skin-directed therapies, such as phototherapy and radiation therapy. Daily oral administration of etoposide plus prednisolone (EP) is also used for smoldering-type ATLL. However, it remains unclear whether these therapies improve patients' survival. We retrospectively analyzed the prognosis of patients with smoldering, skin lesion-bearing ATLL (n = 62), who were treated, as first therapy, with one skin-directed therapy (n = 29), oral EP alone (n = 14) or a combination of skin-directed therapy and oral EP (n = 19). Multivariate analysis revealed that the hazard ratios (HRs) for the overall survival (OS) and progression-free survival (PFS) with the combination therapy were significantly lower than those with the skin-directed therapy (HR 0.1, p = 0.001; HR 0.2, p = 0.002, respectively). These results suggest that the combination of skin-directed therapy and oral EP improves the clinical outcome of patients with smoldering, skin lesion-bearing ATLL.

• Authors: Yu Sawada, Takatoshi Shimauchi, Takashi Yamaguchi, Risa Okura, Kayo Hama-Yamamoto, Haruna Fueki-Yoshioka, Shun Ohmori, Shigenori Yamada, Mayuko Yoshizawa, Kana Hiromasa, Makiko Tajiri, Rieko Kabashima-Kubo, Manabu Yoshioka, Kazunari Sugita, Ryutaro Yoshiki, Ryosuke Hino, Miwa Kobayashi, Kunio Izu, Motonobu Nakamura, Yoshiki Tokura
• Journal: Leukemia & lymphoma (Leuk Lymphoma) Vol. 54 Issue 3 Pg. 520-7 (Mar 2013) ISSN: 1029-2403 [Electronic] United States
• PMID: 22830614 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Etoposide
• Prednisolone

Topics

• Administration, Oral
• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, adverse effects, therapeutic use)
• Combined Modality Therapy
• Drug Administration Schedule
• Etoposide (administration & dosage, adverse effects)
• Fatigue (etiology)
• Female
• Humans
• Kaplan-Meier Estimate
• Leukemia-Lymphoma, Adult T-Cell (pathology, therapy)
• Leukopenia (etiology)
• Male
• Middle Aged
• Multivariate Analysis
• Outcome Assessment, Health Care (statistics & numerical data)
• Prednisolone (administration & dosage, adverse effects)
• Proportional Hazards Models
• Retrospective Studies
• Skin (pathology, radiation effects)
• Ultraviolet Therapy (adverse effects, methods)
• Vomiting (etiology)