Use of Zidovudine and Interferon Alfa With Chemotherapy Improves Survival in Both Acute and Lymphoma Subtypes of Adult T-Cell Leukemia/Lymphoma
Adult T-cell leukemia/lymphoma (ATLL) is a mature (post-thymic) T-cell lymphoma associated with human T-lymphotropic virus type 1 infection. Survival in aggressive subtypes remains poor, and treatment resistance is frequent. Use of zidovudine (ZDV) and interferon alfa (IFN-α) has been associated wit...
Saved in:
Published in | Journal of clinical oncology Vol. 29; no. 35; pp. 4696 - 4701 |
---|---|
Main Authors | , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Alexandria, VA
American Society of Clinical Oncology
10.12.2011
|
Subjects | |
Online Access | Get full text |
Cover
Loading…
Abstract | Adult T-cell leukemia/lymphoma (ATLL) is a mature (post-thymic) T-cell lymphoma associated with human T-lymphotropic virus type 1 infection. Survival in aggressive subtypes remains poor, and treatment resistance is frequent. Use of zidovudine (ZDV) and interferon alfa (IFN-α) has been associated with improved response rates in small studies and prolonged overall survival in leukemic ATLL subtypes in a recent meta-analysis.
We report the clinicopathologic characteristics, treatment, and outcome of 73 patients with aggressive ATLL (acute ATLL, 29; lymphoma ATLL, 44) diagnosed and treated in England between 1999 and 2009. The impact of ZDV/IFN-α on treatment response and survival was assessed.
The overall response rate ranged from 49% with chemotherapy alone to 81% with combined first-line therapy (chemotherapy with concurrent/sequential ZDV/IFN-α). Median overall survival (OS) was 9 months: 7.5 months for acute ATLL and 10 months for lymphoma ATLL. Use of ZDV/IFN-α at any time prolonged survival in acute (P < .001) and lymphoma ATLL (P < .001) and was the sole factor associated with reduction in risk of death in aggressive ATLL (hazard ratio, 0.23; 95% CI, 0.09 to 0.60; P = .002). Combined first-line therapy prolonged median OS in acute (P = .0081) and lymphoma ATLL (P = .001) compared with chemotherapy alone.
These data support the use of low-dose ZDV/IFN-α with chemotherapy in first-line treatment of acute and lymphoma ATLL. |
---|---|
AbstractList | Adult T-cell leukemia/lymphoma (ATLL) is a mature (post-thymic) T-cell lymphoma associated with human T-lymphotropic virus type 1 infection. Survival in aggressive subtypes remains poor, and treatment resistance is frequent. Use of zidovudine (ZDV) and interferon alfa (IFN-α) has been associated with improved response rates in small studies and prolonged overall survival in leukemic ATLL subtypes in a recent meta-analysis.
We report the clinicopathologic characteristics, treatment, and outcome of 73 patients with aggressive ATLL (acute ATLL, 29; lymphoma ATLL, 44) diagnosed and treated in England between 1999 and 2009. The impact of ZDV/IFN-α on treatment response and survival was assessed.
The overall response rate ranged from 49% with chemotherapy alone to 81% with combined first-line therapy (chemotherapy with concurrent/sequential ZDV/IFN-α). Median overall survival (OS) was 9 months: 7.5 months for acute ATLL and 10 months for lymphoma ATLL. Use of ZDV/IFN-α at any time prolonged survival in acute (P < .001) and lymphoma ATLL (P < .001) and was the sole factor associated with reduction in risk of death in aggressive ATLL (hazard ratio, 0.23; 95% CI, 0.09 to 0.60; P = .002). Combined first-line therapy prolonged median OS in acute (P = .0081) and lymphoma ATLL (P = .001) compared with chemotherapy alone.
These data support the use of low-dose ZDV/IFN-α with chemotherapy in first-line treatment of acute and lymphoma ATLL. PURPOSEAdult T-cell leukemia/lymphoma (ATLL) is a mature (post-thymic) T-cell lymphoma associated with human T-lymphotropic virus type 1 infection. Survival in aggressive subtypes remains poor, and treatment resistance is frequent. Use of zidovudine (ZDV) and interferon alfa (IFN-α) has been associated with improved response rates in small studies and prolonged overall survival in leukemic ATLL subtypes in a recent meta-analysis.PATIENTS AND METHODSWe report the clinicopathologic characteristics, treatment, and outcome of 73 patients with aggressive ATLL (acute ATLL, 29; lymphoma ATLL, 44) diagnosed and treated in England between 1999 and 2009. The impact of ZDV/IFN-α on treatment response and survival was assessed.RESULTSThe overall response rate ranged from 49% with chemotherapy alone to 81% with combined first-line therapy (chemotherapy with concurrent/sequential ZDV/IFN-α). Median overall survival (OS) was 9 months: 7.5 months for acute ATLL and 10 months for lymphoma ATLL. Use of ZDV/IFN-α at any time prolonged survival in acute (P < .001) and lymphoma ATLL (P < .001) and was the sole factor associated with reduction in risk of death in aggressive ATLL (hazard ratio, 0.23; 95% CI, 0.09 to 0.60; P = .002). Combined first-line therapy prolonged median OS in acute (P = .0081) and lymphoma ATLL (P = .001) compared with chemotherapy alone.CONCLUSIONThese data support the use of low-dose ZDV/IFN-α with chemotherapy in first-line treatment of acute and lymphoma ATLL. Purpose Adult T-cell leukemia/lymphoma (ATLL) is a mature (post-thymic) T-cell lymphoma associated with human T-lymphotropic virus type 1 infection. Survival in aggressive subtypes remains poor, and treatment resistance is frequent. Use of zidovudine (ZDV) and interferon alfa (IFN-α) has been associated with improved response rates in small studies and prolonged overall survival in leukemic ATLL subtypes in a recent meta-analysis. Patients and Methods We report the clinicopathologic characteristics, treatment, and outcome of 73 patients with aggressive ATLL (acute ATLL, 29; lymphoma ATLL, 44) diagnosed and treated in England between 1999 and 2009. The impact of ZDV/IFN-α on treatment response and survival was assessed. Results The overall response rate ranged from 49% with chemotherapy alone to 81% with combined first-line therapy (chemotherapy with concurrent/sequential ZDV/IFN-α). Median overall survival (OS) was 9 months: 7.5 months for acute ATLL and 10 months for lymphoma ATLL. Use of ZDV/IFN-α at any time prolonged survival in acute (P < .001) and lymphoma ATLL (P < .001) and was the sole factor associated with reduction in risk of death in aggressive ATLL (hazard ratio, 0.23; 95% CI, 0.09 to 0.60; P = .002). Combined first-line therapy prolonged median OS in acute (P = .0081) and lymphoma ATLL (P = .001) compared with chemotherapy alone. Conclusion These data support the use of low-dose ZDV/IFN-α with chemotherapy in first-line treatment of acute and lymphoma ATLL. |
Author | Kate Cwynarski Graham P. Taylor Paul A. Fields Thurai Kumaran Andrew Hodson Kirit M. Ardeshna Siobhan Crichton Silvia Montoto Estella Matutes Naheed Mir Antonio Pagliuca |
Author_xml | – sequence: 1 givenname: Andrew surname: HODSON fullname: HODSON, Andrew organization: National Centre for Human Retrovirology, St Mary's Hospital, Imperial College Healthcare National Health Service (NHS) Trust, United Kingdom – sequence: 2 givenname: Siobhan surname: CRICHTON fullname: CRICHTON, Siobhan organization: King's College London, United Kingdom – sequence: 3 givenname: Paul A surname: FIELDS fullname: FIELDS, Paul A organization: Guy's and St Thomas' NHS Foundation Trust, Kings Health Partners, London, United Kingdom – sequence: 4 givenname: Silvia surname: MONTOTO fullname: MONTOTO, Silvia organization: Barts Cancer Institute, Queen Mary University of London, United Kingdom – sequence: 5 givenname: Naheed surname: MIR fullname: MIR, Naheed organization: University Hospital Lewisham NHS Trust, United Kingdom – sequence: 6 givenname: Estella surname: MATUTES fullname: MATUTES, Estella organization: Royal Marsden NHS Foundation Trust, United Kingdom – sequence: 7 givenname: Kate surname: CWYNARSKI fullname: CWYNARSKI, Kate organization: Royal Free Hampstead NHS Trust, United Kingdom – sequence: 8 givenname: Thurai surname: KUMARAN fullname: KUMARAN, Thurai organization: North Middlesex University Hospital, United Kingdom – sequence: 9 givenname: KiritM surname: ARDESHNA fullname: ARDESHNA, KiritM organization: University College Hospital NHS Foundation Trust, United Kingdom – sequence: 10 givenname: Antonio surname: PAGLIUCA fullname: PAGLIUCA, Antonio organization: King's College Hospital, Kings Health Partners, United Kingdom – sequence: 11 givenname: Graham P surname: TAYLOR fullname: TAYLOR, Graham P organization: Imperial College, United Kingdom |
BackLink | http://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25313875$$DView record in Pascal Francis https://www.ncbi.nlm.nih.gov/pubmed/22042945$$D View this record in MEDLINE/PubMed |
BookMark | eNpFkU1v1DAQhi3Uim4Ld07IF9RTtv6I4-S4RBQWrdQDrUBcLG88Ji5JHOxk0f4K_jJe7bY9jUbzzDsf7yU6G_wACL2jZEkZITdf67slI5QuuVgKIctXaEEFk5mUQpyhBZGcZbTkPy7QZYyPhNC85OI1umCM5KzKxQL9e4iAvcU_nfG72bgBsB4MXg8TBAvBD3jVWY2_u6nFdQu9n1oIetzjdT8Gv4OIv81h53a6w27AH1MZr5p5Oqps9v3Y-l4nZjvtxwSnSSszdxO-z2roOryB-Tf0Tt88oW_QudVdhLeneIUebj_d11-yzd3ndb3aZE1O2JTJAmQhJTSagbElKVNWSkONltbkTGhDcisIgCkJL6QgopDU8K0B4FZLwq_Q9VE3XfFnhjip3sUmraQH8HNUFaUVF0yUiSRHsgk-xgBWjcH1OuwVJerggkouqIMLigt1cCG1vD-Jz9sezHPD09sT8OEE6NjozgY9NC6-cIJTXkrxsmXrfrV_XQAVe911SZapx8az6jAyL6qC_wc7saAc |
CitedBy_id | crossref_primary_10_2478_ahp_2019_0017 crossref_primary_10_1182_blood_2016_02_698936 crossref_primary_10_1182_blood_2019004045 crossref_primary_10_1002_ajh_25513 crossref_primary_10_1002_adbi_201900237 crossref_primary_10_1038_bmt_2014_143 crossref_primary_10_1200_JCO_18_00501 crossref_primary_10_3390_pathogens9050342 crossref_primary_10_1016_S2055_6640_20_30242_9 crossref_primary_10_1007_s11356_021_16726_w crossref_primary_10_1097_QCO_0000000000000027 crossref_primary_10_1007_s12032_023_02166_8 crossref_primary_10_1016_S1470_2045_14_70202_5 crossref_primary_10_1128_cmr_00078_21 crossref_primary_10_1586_17469872_2013_838041 crossref_primary_10_3960_jslrt_17008 crossref_primary_10_1177_23247096211013235 crossref_primary_10_1002_ajh_27165 crossref_primary_10_1111_bjh_12788 crossref_primary_10_1111_bjh_17951 crossref_primary_10_1002_ajh_26270 crossref_primary_10_1016_j_medcli_2016_10_005 crossref_primary_10_1186_s12985_023_02077_0 crossref_primary_10_3389_fmicb_2020_01207 crossref_primary_10_1007_s11864_023_01111_1 crossref_primary_10_1111_bjh_18363 crossref_primary_10_1038_bmt_2016_154 crossref_primary_10_1016_j_biopha_2018_10_139 crossref_primary_10_1053_j_seminhematol_2021_02_005 crossref_primary_10_1016_j_beha_2013_04_001 crossref_primary_10_1016_j_semcancer_2013_11_003 crossref_primary_10_1016_S2352_3026_15_00284_7 crossref_primary_10_1371_journal_ppat_1006030 crossref_primary_10_3390_cancers7040893 crossref_primary_10_1016_j_hoc_2016_11_005 crossref_primary_10_1016_j_medcle_2017_02_015 crossref_primary_10_1016_j_prp_2024_155172 crossref_primary_10_1097_CCO_0b013e32835793f1 crossref_primary_10_18632_oncotarget_7162 crossref_primary_10_2217_fon_2021_1032 crossref_primary_10_1111_imr_12248 crossref_primary_10_1155_2013_132793 crossref_primary_10_1089_aid_2012_0185 crossref_primary_10_1016_j_ccell_2018_06_014 crossref_primary_10_1016_j_bbmt_2017_07_027 crossref_primary_10_1097_IPC_0000000000001112 crossref_primary_10_1007_s11899_012_0139_9 crossref_primary_10_1016_j_leukres_2011_12_004 crossref_primary_10_1007_s11899_018_0458_6 crossref_primary_10_1007_s11912_021_01138_3 crossref_primary_10_1097_CCO_0000000000000883 crossref_primary_10_1007_s44228_023_00032_y crossref_primary_10_1155_2015_476805 crossref_primary_10_3389_fmicb_2020_01062 |
Cites_doi | 10.7326/0003-4819-106-3-361 10.1182/blood-2009-03-211821 10.1097/00042560-199600001-00005 10.1182/blood-2006-07-036368 10.1111/j.1365-2141.1991.tb08051.x 10.1200/JCO.2007.11.9958 10.1002/ijc.2910450206 10.3109/10428199609054865 10.1056/NEJM199506293322603 10.1016/S0140-6736(82)92200-0 10.1136/bmj.320.7235.611 10.1097/00042560-199600001-00004 10.1182/blood.V108.11.2750.2750 10.1056/NEJM199506293322604 10.1182/blood-2009-12-257410 10.3324/haematol.10703 10.1182/blood-2006-01-0067 10.3109/10428199809057597 10.1002/ijc.2910430214 10.1046/j.1365-2141.2001.02737.x 10.1038/sj.onc.1208979 10.2169/internalmedicine.34.947 10.1046/j.1365-2141.2001.02794.x 10.1200/JCO.2010.28.0669 10.1371/journal.pone.0004420 10.1200/JCO.2009.25.3575 |
ContentType | Journal Article |
Copyright | 2015 INIST-CNRS |
Copyright_xml | – notice: 2015 INIST-CNRS |
DBID | IQODW CGR CUY CVF ECM EIF NPM AAYXX CITATION 7X8 |
DOI | 10.1200/JCO.2011.35.5578 |
DatabaseName | Pascal-Francis Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed CrossRef MEDLINE - Academic |
DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) CrossRef MEDLINE - Academic |
DatabaseTitleList | MEDLINE MEDLINE - Academic CrossRef |
Database_xml | – sequence: 1 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: EIF name: MEDLINE url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search sourceTypes: Index Database |
DeliveryMethod | fulltext_linktorsrc |
Discipline | Medicine Pharmacy, Therapeutics, & Pharmacology |
EISSN | 1527-7755 |
EndPage | 4701 |
ExternalDocumentID | 10_1200_JCO_2011_35_5578 22042945 25313875 jco29_35_4696 |
Genre | Journal Article |
GroupedDBID | - 0R 2WC 34G 39C 3O- 4.4 53G 55 5GY 5RE 8F7 AAPEM AARDX AAWTL AAYEP ABFLS ABOCM ACDCL ACGFS ADBBV ADKWQ AENEX AFFNX ALMA_UNASSIGNED_HOLDINGS AWKKM BAWUL CS3 DIK EBS EJD F5P FD8 FH7 GX1 H13 HZ IH2 K-O KQ8 L7B LSO N9A O9- OK1 OVD OWW P2P RHI RUC SJN SV3 TWZ UDS VH1 WH7 X7M YCJ ZA5 --- .55 .GJ 08G 08P 08R 0R~ 18M 29K 5VS 8WZ A6W AAKAS AAQQT AAUGY AAYOK ACGFO ADZCM AEGXH AI. AIAGR ASPBG AVWKF AZFZN C45 D-I EX3 F9R FBNNL FEDTE HZ~ IPNFZ IQODW J5H MJL N4W NTWIH QTD R1G RIG RLZ TEORI TR2 UHU VVN WOQ WOW YFH YQY ZGI ABJNI ACGUR CGR CUY CVF ECM EIF NPM AAYXX CITATION 7X8 |
ID | FETCH-LOGICAL-c402t-76e7677eca2edf80876787d1da7fd425ad04f50eed80367505671d3bdee3fa703 |
ISSN | 0732-183X |
IngestDate | Fri Aug 16 14:26:37 EDT 2024 Fri Aug 23 00:39:42 EDT 2024 Sat Sep 28 07:50:15 EDT 2024 Sun Oct 22 16:08:29 EDT 2023 Tue Jan 05 20:16:29 EST 2021 |
IsDoiOpenAccess | false |
IsOpenAccess | true |
IsPeerReviewed | true |
IsScholarly | true |
Issue | 35 |
Keywords | RNA-directed DNA polymerase Alpha interferon Adult T cell leukemia lymphoma Cancerology Reverse transcriptase inhibitor Lymphoproliferative syndrome Nucleoside analog Antiviral Pyrimidine nucleoside Enzyme Transferases Acute Enzyme inhibitor Malignant hemopathy Lymphoid neoplasm Non Hodgkin lymphoma Survival Infection Nucleotidyltransferases Chemotherapy Treatment Dideoxynucleoside Viral disease Subtype Zidovudine Interferon alfa Cancer |
Language | English |
License | CC BY 4.0 |
LinkModel | OpenURL |
MergedId | FETCHMERGED-LOGICAL-c402t-76e7677eca2edf80876787d1da7fd425ad04f50eed80367505671d3bdee3fa703 |
Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
OpenAccessLink | https://ascopubs.org/doi/pdfdirect/10.1200/JCO.2011.35.5578?role=tab |
PMID | 22042945 |
PQID | 911935258 |
PQPubID | 23479 |
PageCount | 6 |
ParticipantIDs | proquest_miscellaneous_911935258 crossref_primary_10_1200_JCO_2011_35_5578 pubmed_primary_22042945 pascalfrancis_primary_25313875 highwire_smallpub2_jco29_35_4696 |
ProviderPackageCode | RHI |
PublicationCentury | 2000 |
PublicationDate | 2011-12-10 |
PublicationDateYYYYMMDD | 2011-12-10 |
PublicationDate_xml | – month: 12 year: 2011 text: 2011-12-10 day: 10 |
PublicationDecade | 2010 |
PublicationPlace | Alexandria, VA |
PublicationPlace_xml | – name: Alexandria, VA – name: United States |
PublicationTitle | Journal of clinical oncology |
PublicationTitleAlternate | J Clin Oncol |
PublicationYear | 2011 |
Publisher | American Society of Clinical Oncology |
Publisher_xml | – name: American Society of Clinical Oncology |
References | B20 Dougan S (B8) 2004; 7 B21 B22 B23 B24 B25 B26 B27 B28 B29 B10 B11 B12 B13 B15 B16 B17 B18 B19 Matutes E (B14) 1994 B1 B2 B3 B4 B5 B6 B7 B9 |
References_xml | – ident: B9 doi: 10.7326/0003-4819-106-3-361 – ident: B28 doi: 10.1182/blood-2009-03-211821 – ident: B3 doi: 10.1097/00042560-199600001-00005 – ident: B26 doi: 10.1182/blood-2006-07-036368 – ident: B7 doi: 10.1111/j.1365-2141.1991.tb08051.x – ident: B1 – volume: 7 start-page: 207 year: 2004 ident: B8 publication-title: Commun Dis Public Health contributor: fullname: Dougan S – ident: B22 doi: 10.1200/JCO.2007.11.9958 – ident: B4 doi: 10.1002/ijc.2910450206 – ident: B10 doi: 10.3109/10428199609054865 – ident: B18 doi: 10.1056/NEJM199506293322603 – ident: B13 doi: 10.1016/S0140-6736(82)92200-0 – ident: B2 doi: 10.1136/bmj.320.7235.611 – ident: B12 doi: 10.1097/00042560-199600001-00004 – ident: B17 doi: 10.1182/blood.V108.11.2750.2750 – ident: B19 doi: 10.1056/NEJM199506293322604 – ident: B6 doi: 10.1182/blood-2009-12-257410 – ident: B27 doi: 10.3324/haematol.10703 – ident: B25 doi: 10.1182/blood-2006-01-0067 – ident: B15 doi: 10.3109/10428199809057597 – ident: B5 doi: 10.1002/ijc.2910430214 – ident: B20 doi: 10.1046/j.1365-2141.2001.02737.x – ident: B23 doi: 10.1038/sj.onc.1208979 – ident: B11 doi: 10.2169/internalmedicine.34.947 – ident: B16 doi: 10.1046/j.1365-2141.2001.02794.x – ident: B21 doi: 10.1200/JCO.2010.28.0669 – ident: B24 doi: 10.1371/journal.pone.0004420 – ident: B29 doi: 10.1200/JCO.2009.25.3575 – start-page: 113 volume-title: Adult T-Cell Leukaemia year: 1994 ident: B14 contributor: fullname: Matutes E |
SSID | ssj0014835 |
Score | 2.332324 |
Snippet | Adult T-cell leukemia/lymphoma (ATLL) is a mature (post-thymic) T-cell lymphoma associated with human T-lymphotropic virus type 1 infection. Survival in... Purpose Adult T-cell leukemia/lymphoma (ATLL) is a mature (post-thymic) T-cell lymphoma associated with human T-lymphotropic virus type 1 infection. Survival... PURPOSEAdult T-cell leukemia/lymphoma (ATLL) is a mature (post-thymic) T-cell lymphoma associated with human T-lymphotropic virus type 1 infection. Survival in... |
SourceID | proquest crossref pubmed pascalfrancis highwire |
SourceType | Aggregation Database Index Database Publisher |
StartPage | 4696 |
SubjectTerms | Acute Disease Adult Aged Aged, 80 and over Antineoplastic Combined Chemotherapy Protocols - therapeutic use Biological and medical sciences Female Hematologic and hematopoietic diseases Humans Interferon-alpha - administration & dosage Leukemia-Lymphoma, Adult T-Cell - drug therapy Leukemia-Lymphoma, Adult T-Cell - pathology Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis Male Medical sciences Middle Aged Retrospective Studies Survival Analysis Tumors Young Adult Zidovudine - administration & dosage |
Title | Use of Zidovudine and Interferon Alfa With Chemotherapy Improves Survival in Both Acute and Lymphoma Subtypes of Adult T-Cell Leukemia/Lymphoma |
URI | http://jco.ascopubs.org/content/29/35/4696.abstract https://www.ncbi.nlm.nih.gov/pubmed/22042945 https://search.proquest.com/docview/911935258 |
Volume | 29 |
hasFullText | 1 |
inHoldings | 1 |
isFullTextHit | |
isPrint | |
link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1ba9swFBZZB2MvY-tu2aXoYRRG6jaW7ch-zMK6MNqlDwmEvRjZlki2xC6JE8j-xP7qfsLOsSzb6VZ2gWCCSWQl3_nOkY7OhZA3oie54yS-paLAhQ2KrazAj20LNltBDObYixSe6F5-6g0n7sepN221fjSiljZ5dBp_-21eyf-gCvcAV8yS_Qdkq0HhBrwHfOEKCMP1rzCeaEf853mSbTcJrhd1dC-2npYrwLW_UAKIj3lGM7ksk612He1JkGtQG6AptkXdjc67DA9wYowbwFEudoBzthSoWtBPW4R89LFaR2dsDdDjdyE3X-USg23PzYdvWepW6ZdZGu-58XU4ZWeYYeJX5eyZZ9EM1M4AVPQsb95fbOcCtVCe5VnlxRYzMMCdy_mq6cDACDpmlaGsdc4AKrMyTBXDUMy0Rs1paa3IHfi6XzQRBgNWam3GYZug6_0atV46UrT4Ol5DSbs93UT3F-vBdGPswUiXdnW8U8_TDYYawnS9LKSJMTTluhTmfhnvG-a1Cnr8EmcsCB0vxOffIXcZDzwMQv0wrYKSYG-qW8KaH1kerMPEzm5OC8tYl3PYX1OZOtcY5ivW8C8q3aLl9j1UsZYaPyQPSsmgfS3Rj0hLpofk3mUZ5nFIjq90QfXdCR3X-YHrE3pMr-pS67vH5DswgGaK1gygILu0ZgBFBlBkAG0ygBoGUMMAOk8pMoAWDChGMUJNDQPwSQUDqGYANQw4Mx99Qibn78eDoVW2GLFit8tyi4Oq6nEuY8FkonyszwgWLLETwVUC5kwkXVd5XZBjH5Z6HLcL3E6cKJHSUQKs5VNykGapfE6oo2zW87ux7doJvGzheDyRIlK2lEzYvE3eGpDCa11JJsQdOMPj5MEoRGxROhDbNqEGxXC9FIsFoMXCPQFqk6M9dKsxGVhVx-cejGHgDsFk4DmgSGW2WYewvgmwCjI85pkWg_rLpUS9-PMEXpL7NZtfkYN8tZGvYYGeR0eFTP8EydXpsg |
link.rule.ids | 315,786,790,27955,27956 |
linkProvider | Geneva Foundation for Medical Education and Research |
openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Use+of+Zidovudine+and+Interferon+Alfa+With+Chemotherapy+Improves+Survival+in+Both+Acute+and+Lymphoma+Subtypes+of+Adult+T-Cell+Leukemia%2FLymphoma&rft.jtitle=Journal+of+clinical+oncology&rft.au=Andrew+Hodson&rft.au=Siobhan+Crichton&rft.au=Silvia+Montoto&rft.au=Naheed+Mir&rft.date=2011-12-10&rft.pub=American+Society+of+Clinical+Oncology&rft.issn=0732-183X&rft.eissn=1527-7755&rft.volume=29&rft.issue=35&rft.spage=4696&rft_id=info:doi/10.1200%2FJCO.2011.35.5578&rft_id=info%3Apmid%2F22042945&rft.externalDBID=n%2Fa&rft.externalDocID=jco29_35_4696 |
thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0732-183X&client=summon |
thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0732-183X&client=summon |
thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0732-183X&client=summon |