Different prognostic factors for survival in acute and lymphomatous adult T-cell leukemia/lymphoma

Leuk Res. 2011 Mar;35(3):334-9. doi: 10.1016/j.leukres.2010.08.006. Epub 2010 Sep 15.


Introduction: Adult T-cell leukemia/lymphoma (ATLL) is a clinically aggressive and heterogeneous entity; hence it is likely that different variants of ATLL have different prognostic factors.

Methods: 95 patients with ATLL seen at our institution between 1987 and 2008 were included. Clinical data were compared, according to ATLL variant, using the Mann-Whitney and the Chi-square tests for continuous and categorical variables, respectively. Kaplan-Meier estimates compared using the log-rank test and Cox proportional-hazard test were used for the univariate and multivariate analysis, respectively.

Results: Median age was 61 years with male-to-female ratio of 1.07:1. Patients with acute ATLL were more likely to present with bone marrow, liver and spleen involvement, higher β2-microglobulin and lower albumin levels. Poor performance status, high IPI score, presence of B symptoms, high LDH and low albumin levels were associated with a worse survival in lymphomatous ATLL. High LDH, high β2-microglobulin and high PIT score were associated with worse survival in acute ATLL. In the multivariate analysis, low albumin level and presence of B symptoms were independent factors for worse survival in lymphomatous ATLL, and high β2-microglobulin level was independent factor for worse survival in acute ATLL.

Conclusions: Aggressive ATLL variants have a distinct, almost mutually exclusive profile of prognostic factors.

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Aged, 80 and over
  • Albumins / metabolism*
  • Biomarkers, Tumor / metabolism*
  • Calcium / metabolism
  • Female
  • Flow Cytometry
  • Humans
  • L-Lactate Dehydrogenase / metabolism*
  • Leukemia-Lymphoma, Adult T-Cell / diagnosis
  • Leukemia-Lymphoma, Adult T-Cell / metabolism
  • Leukemia-Lymphoma, Adult T-Cell / mortality*
  • Male
  • Middle Aged
  • Prognosis
  • Survival Rate
  • Young Adult
  • beta 2-Microglobulin / metabolism*


  • Albumins
  • Biomarkers, Tumor
  • beta 2-Microglobulin
  • L-Lactate Dehydrogenase
  • Calcium