Katsuya et al reported a prognostic index for evaluating a patient with the acute-type or lymphoma-type of adult T-cell leukemia/lymphoma (ATL). This can help to identify a patient who may benefit from ore aggressive therapy. The authors are from multiple hospitals in Japan.
Patient selection: acute or lymphoma type of ATL (not the chronic or smoldering types)
Parameters:
(1) clinical stage
(2) ECOG performance scale
(3) age in years
(4) serum albumin in g/dL
(5) soluble IL-2 receptor in U/mL
ATL prognostic index =
= (0.65 if Stage III or IV) + (0.35 if ECOG 2 to 4) + (0.016 * (age in years)) - (0.36 * (serum albumin in g/dL)) + (0.37 * LOG10(soluble IL-2 receptor in U/mL))
ATL-PI |
Level |
Overall Survival at 2 years from diagnosis |
---|---|---|
< 1.6 |
low |
29% |
1.6 to 2.59 |
intermediate |
12% |
>= 2.6 |
high |
4% (0% at 3 years) |
The authors also developed a prognostic score
Parameter |
Finding |
Points |
---|---|---|
clinical stage |
I or II |
0 |
|
III or IV |
2 |
ECOG performance scale |
0 or 1 |
0 |
|
2, 3 or 4 |
1 |
age in years |
<= 70 years |
0 |
|
> 70 years |
1 |
serum albumin |
>= 3.5 g/dL |
0 |
|
< 3.5 g/dL |
1 |
soluble IL-2 receptor |
<= 20,000 U/mL |
0 |
|
> 20,000 U/mL |
1 |
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• The higher the score the worse the prognosis.
Total Score |
Risk Level |
Overall Survival at 2 years from diagnosis |
---|---|---|
0 to 2 |
low |
29% |
3 or 4 |
intermediate |
13% |
5 or 6 |
high |
5% |
After 3 years the curves for low and intermediate scores are close to each other. Survival is 0% for the high risk group after 27 months.
Purpose: To evaluate an adult with acute or lymphoma type of T-cell leukemia/lymphoma using the prognostic score of Katsuya et al.
Specialty: Hematology Oncology
Objective: risk factors, severity, prognosis, stage, complications, selection
ICD-10: C84, C91,