ATL Prognosis - Index for Evaluation of Patients

Description

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.

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Description

Specialty

Objective

ICD-10

Prognostic Index of Katsuya et al for a Patient with Acute and Lymphoma Types of Adult T-Cell Leukemia/Lymphoma (ATL-PI)

Purpose: To evaluate an adult with acute or lymphoma type of T-cell leukemia/lymphoma using the prognostic score of Katsuya et al.

Description

Specialty

Objective

ICD-10