Type of skin eruption is an independent prognostic indicator for adult T-cell leukemia/lymphoma

• Published in: Blood Vol. 117; no. 15; pp. 3961 - 3967
• Main Authors: Sawada, Yu, Hino, Ryosuke, Hama, Kayo, Ohmori, Shun, Fueki, Haruna, Yamada, Shigenori, Fukamachi, Shoko, Tajiri, Makiko, Kubo, Rieko, Yoshioka, Manabu, Nakashima, Daiki, Sugita, Kazunari, Yoshiki, Ryutaro, Shimauchi, Takatoshi, Mori, Tomoko, Izu, Kunio, Kobayashi, Miwa, Nakamura, Motonobu, Tokura, Yoshiki
• Format: Journal Article
• Language: English
• Published: Washington, DC Elsevier Inc 14.04.2011; Americain Society of Hematology
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Female; Hematologic and hematopoietic diseases; Human viral diseases; Humans; Infectious diseases; Kaplan-Meier Estimate; Leukemia-Lymphoma, Adult T-Cell - classification; Leukemia-Lymphoma, Adult T-Cell - mortality; Leukemia-Lymphoma, Adult T-Cell - pathology; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Male; Medical sciences; Middle Aged; Multivariate Analysis; Predictive Value of Tests; Prognosis; Skin - pathology; Skin Neoplasms - classification; Skin Neoplasms - mortality; Skin Neoplasms - pathology; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Young Adult; Infection; Prognosis; Hematology; Lymphoproliferative syndrome; Viral disease; Adult T cell leukemia lymphoma; Malignant hemopathy; Skin; Non Hodgkin lymphoma; Cancer
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood-2010-11-316794

Cutaneous involvement is seen in ∼ 50% of adult T-cell leukemia/lymphoma (ATLL) patients. We investigated the association between skin eruption type and prognosis in 119 ATLL patients. ATLL eruptions were categorized into patch (6.7%), plaque (26.9%), multipapular (19.3%), nodulotumoral (38.7%), erythrodermic (4.2%), and purpuric (4.2%) types. When the T stage of the tumor-node-metastasis-blood (TNMB) classification of mycosis fungoides/Sézary syndrome was applied to ATLL staging, 16.0% were T1, 17.7% T2, 38.7% T3, and 4.2% T4, and the remaining 23.5% were of the multipapular and purpuric types. For the patch type, the mean survival time (median survival time could not be estimated) was 188.4 months. The median survival times (in months) for the remaining types were as follows: plaque, 114.9; multipapular, 17.3; nodulotumoral, 17.3; erythrodermic, 3.0; and purpuric, 4.4. Kaplan-Meier curves of overall survival showed that the erythrodermic type had the poorest prognosis, followed by the nodulotumoral and multipapular types. The patch and plaque types were associated with better survival rates. Multivariate analysis demonstrated that the hazard ratios of the erythrodermic and nodulotumoral types were significantly higher than that of the patch type, and that the eruption type is an independent prognostic factor for ATLL. The overall survival was worse as the T stage became more advanced: the multipapular type and T2 were comparable, and the purpuric type had a significantly poorer prognosis than T1.