Abstract
Adult T-cell leukemia/lymphoma (ATLL) is an incurable neoplasm of mature T-cells with a median survival time of approximately one year. The aim of this study was to compare the clinical value of soluble CD30 (sCD30) levels with soluble IL-2 receptor α chain (sIL-2R) levels in two different clinical settings of ATLL patients; before an initial therapy of chemotherapy or gastric resection (n=32), and before allogeneic hematopoietic stem cell transplantation (HSCT; n=24). All patients completed the 2-year follow-up. Both sIL-2R (p=0.016) and sCD30 (p=0.030) levels were significant predictors of overall survival before the initial therapy. The number of ATLL cells in peripheral blood (PB) was correlated with sCD30 levels (Spearman’s correlation coefficient, ρ=0.46; p=0.009) but not with sIL-2R levels (ρ=0.16; P=0.38). Patients who survived for longer than two years, and for whom the percentage of ATLL cells in PB were <5%, displayed relatively low sCD30 levels, but this tendency for low sCD30 levels was not observed in longterm survivors whose ATLL cells constituted ≥5% of PB cells. sIL-2R (p=0.041) and sCD30 (p=0.0003) values were both significant predictors of overall survival in HSCT, but sCD30 levels predicted more patients with early death than were predicted by sIL-2R levels. Combination of sCD30 and CRP levels showed high sensitivity and specificity for detection of early death (within 100 days) following HSCT (81.8% and 84.6%, respectively). These results suggest that analysis of sCD30 levels may be useful for prediction of overall survival in ATLL patients, especially before HSCT. These findings would alter the treatment strategy and improve the prognosis of ATLL.
Highlights
In 1977, Takatsuki et al described a new disease in Japan, adult Tcell leukemia/lymphoma (ATLL) [1]
The 32 patients that were scheduled for initial therapy included 29 patients scheduled for chemotherapy, one patient who died before any therapy, and two patients who were scheduled for total gastrectomy followed by chemotherapy
We evaluated and compared the clinical value of serum levels of Soluble CD30 (sCD30) and soluble IL-2 receptor α chain (sIL-2R) for Adult T-cell leukemia/lymphoma (ATLL) patients
Summary
In 1977, Takatsuki et al described a new disease in Japan, adult Tcell leukemia/lymphoma (ATLL) [1]. Researchers all over the world had been seeking human retrovirus-associated malignant disease and the first human retrovirus, Human T-cell leukemia virus type 1 (HTLV-1) was isolated from patients with ATLL [2,3]. 2–5% of HTLV-1 carriers develop ATLL with a mean latency period of more than 50 years [4]. ATLL patients are usually first treated with chemotherapy. In Japan, younger survivors after chemotherapy are candidates for allogeneic hematopoietic stem cell transplantation (HSCT) [8]. About one thousand people die of ATLL annually in Japan [10]. The reported incidence of transplantation-related mortality (TRM) is as high as 25%–64% [11]
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