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.

Keywords::

• Lymphoma and Hodgkin disease
• lymphoid leukemia
• chemotherapeutic approaches

Acknowledgements

We thank R. Ide (Department of Work Systems and Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health) and Y. Miyamura (Department of Environmental Epidemiology, University of Occupational and Environmental Health) for advising on the statistical analyses.

Y.S. received Grants-in-Aid for Science Research from the Japan Society for the Promotion of Science; and from the Takeda Science Foundation; and Y.T. received Grants-in-Aid for Science Research from the Ministry of Education, Science, Sports, and Culture of Japan; and from the Ministry of Health, Labor and Welfare of Japan.

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