Session: 625. T Cell, NK Cell, or NK/T Cell Lymphomas: Clinical and Epidemiological: Poster II
Hematology Disease Topics & Pathways:
Clinical Practice (Health Services and Quality)
Methods: We prospectively collected clinical information in newly diagnosed patients with ATL on or after April 1, 2021 at all facilities in Kagoshima Prefecture providing hematology services. The follow-up data in registered patients was then collected annually. This study was approved by the ethics committee of each institution.
Results and Discussion; A total of 167 patients were registered during the period of April 1, 2021 to March 31, 2023, of which 161 patients were included in this analysis by excluding 3 patients who were not met the criteria of registration and 3 patients who had duplicated registration. The number of patients was 83, 52, 15, and 13 in acute, lymphoma, chronic, and smoldering types, respectively. In 161 cases, aggressive ATL (acute- and lymphoma-type, and chronic-type with unfavorable prognostic factors) and indolent ATL (smoldering-type and chronic-type without any unfavorable prognostic factors) was 143 cases, 18 cases, respectively. The median age of onset was 72 years old. The median observation period was 19.8 (0.6-35) months, and the median survival was 6.8, 11.6 months, not-reached, and not-reached for acute, lymphoma, chronic, and smoldering types, respectively. Survival stratification by the simplified ATL-prognostic index (sATL-PI) at diagnosis and the Japan Clinical Oncology Group (JCOG)-PI for acute and lymphoma-type ATL, and aggressive ATL were confirmed, respectively (P<0.0001). In aggressive ATL, 83.9 % (120/143) of patients received first-line treatment. Among them, CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone), VCAP-AMP-VECP (VCAP: vincristine, cyclophosphamide, doxorubicin, and prednisolone, AMP: doxorubicin, ranimustine, and prednisolone, and VECP: vindesine, etoposide, carboplatin, and prednisolone), any chemotherapy by cytotoxic agents combined with mogamulizumab (Moga+CTx), and CHP therapy combined with brentuximab vedotin (BV-CHP) were performed in 30.0 %, 28.3 %, 28.3 %, and 13.4% of patients, respectively. Allogeneic stem cell transplantation (Allo-HSCT) was performed in 11.2% (16/143) patients with aggressive ATL with a median age of 62.5 years (44-72 years). Allo-HSCT was performed in 25.9 % (15/58) of patients who were equal or younger than 70 years old at diagnosis. In 34 patients who received Moga+CTx and 16 patients who received BV-CHP in the first-line therapy, 94.1% and 68.7% of patients acquired CR or PR, respectively (P=0.073). The time to next treatment in patients who received Moga+CTx and BV-CHP were 8.1 and 3.2 months, respectively (P=0.0231), indicating that the remission by Moga+CTx was more durable than the BV-CHP in the first-line treatment. Second-line treatment was applied to 81 patients. BV or Moga with or without CTx were most frequently used in the second-line treatment (n=81). This registration is expected to provide real-world data of ATL by regional registry in one of the world’s most endemic area in HTLV-1 under the circumstances of the decreasing of HTLV-1 infected individuals in younger people and recent introduction of novel therapeutic agents including tucidinostat and valemetostat in Japan.
Disclosures: Nakamura: Janssen Pharmaceutical K.K.: Honoraria; Kyowa Kirin Co.,Ltd: Honoraria; Takeda Pharmaceutical Co., Ltd.: Honoraria; Meiji Seika: Honoraria; Chugai Pharmaceutical Co., Ltd.: Honoraria; PharmaEssentia Corp.: Honoraria; Bristol-Myers Squibb K.K.: Honoraria; Daiichi Sankyo Co., Ltd.: Honoraria; AbbVie GK: Honoraria; ASAHI KASEI PHARMA CORPORATION: Honoraria. Owatari: Takeda Pharmaceutical Co., Ltd.: Honoraria; Meiji Seika: Honoraria; Genmab: Honoraria; AbbVie: Honoraria; Janssen Pharmaceutical K.K.: Honoraria; Daiichi Sankyo Co., Ltd.: Honoraria. Miyazono: AbbVie: Honoraria; Janssen: Honoraria; Chugai Pharmaceutical Co., Ltd.: Honoraria; Meiji Seika: Honoraria; Sanofi: Honoraria; Nippon Shinyaku Co., Ltd.: Honoraria; Novartis Pharma K.K.: Honoraria; JCR Pharmaceuticals Co., Ltd.: Honoraria; JIMRO Co., Ltd.: Honoraria; ASAHI KASEI PHARMA CORPORATION: Honoraria. Nakashima: Chugai Pharmaceutical Co., Ltd.: Honoraria; Takeda Pharmaceutical Co., Ltd.: Honoraria; Meiji Seika: Honoraria; Sanofi: Honoraria; Janssen: Honoraria; ONO PHARMACEUTICAL CO., LTD.: Honoraria; Nippon Kayaku Co., Ltd.: Honoraria. Arai: PharmaEssentia Corp.: Honoraria. Yonekura: Meiji Seika: Honoraria; TAIHO PHARMA: Honoraria; Eisai Co., Ltd.: Honoraria; Kyowa Kirin Co., Ltd.: Honoraria; UCBCares Japan.: Honoraria; Nippon Boehringer Ingelheim Co., Ltd.: Honoraria; Eli Lilly Japan K.K.: Honoraria; Sanofi: Honoraria; Daiichi Sankyo Co., Ltd.: Honoraria; LEO Pharma: Honoraria; Janssen Pharmaceutical K.K.: Honoraria; Bristol-Myers Squibb K.K.: Honoraria; Maruho Machinery Solutions Inc.: Honoraria; Minophagen: Honoraria; Sun Pharmaceutical Industries Limited: Honoraria; Eisai Co., Ltd.: Honoraria; AbbVie: Honoraria; SATO PHARMACEUTICAL CO., LTD.: Honoraria. Takeuchi: Sanofi: Honoraria. Fukutoku: Meiji Seika: Honoraria. Shima: AbbVie: Honoraria. Kamada: Janssen: Honoraria; Sanofi: Honoraria; Chugai Pharmaceutical Co., Ltd.: Honoraria; Takeda Pharmaceutical Co., Ltd.: Honoraria; ONO PHARMACEUTICAL CO., LTD.: Honoraria; AbbVie: Honoraria; Nippon Shinyaku Co., Ltd.: Honoraria. Kawada: Meiji: Honoraria. Ito: Chugai Pharmaceutical Co., Ltd.: Honoraria; Bristol-Myers Squibb K.K.: Honoraria; Astellas Pharma Inc.: Honoraria; AstraZeneca K.K.: Honoraria; MSD: Honoraria; AbbVie: Honoraria; AMGEN: Honoraria; Meiji Seika Pharma Co., Ltd.: Honoraria; Otsuka Pharmaceutical Co., Ltd.: Honoraria; Novartis: Honoraria. Hanada: Kyowa Kirin Co., Ltd.: Honoraria. Yoshimitsu: Takeda: Honoraria; Ono Pharmaceutical: Honoraria; Bristol-Myers Squibb Company: Honoraria; Kissei: Honoraria; Daiichi Sankyo: Honoraria; Genmab: Honoraria; Sanofi: Honoraria; PharmaEssentia Corp.: Honoraria; Meiji Seika Pharma Co., Ltd: Honoraria; Asteras: Honoraria; Novartis: Honoraria; Chugai Pharmaceutical: Honoraria; Nippon Kayaku Co., Ltd.: Honoraria. Ishitsuka: Kyowa Kirin Co., Ltd.: Consultancy, Honoraria, Other: All support for the present manuscript (e.g., funding, provision of study materials, medical writing, article processing charges, etc.) ; Ono Pharmaceutical Co., Ltd.: Honoraria, Other: Grants or contracts from any entity.; Kyowa Kirin Co., Ltd.: Consultancy, Honoraria, Other: Grants or contracts from any entity.; Abbvie: Honoraria, Other: Grants or contracts from any entity.; Genmab: Honoraria, Other: Grants or contracts from any entity.; Daiichi Sankyo: Consultancy, Honoraria, Other: Grants or contracts from any entity.; Pfizer: Other: Grants or contracts from any entity.; Bristol Myers Squibb: Honoraria, Other: Grants or contracts from any entity.; Mitsubishi Tanabe pharma: Other: Grants or contracts from any entity.; Incyte: Other: Grants or contracts from any entity.; Yakult: Consultancy, Other: Grants or contracts from any entity.; Lilly: Other: Grants or contracts from any entity.; Meiji Seika: Consultancy, Honoraria; Chugai Pharmaceutical: Honoraria; Janssen: Honoraria; AstraZeneca: Honoraria; Novartis: Honoraria; Sawai: Honoraria; Amgen: Honoraria; Asteras: Honoraria; Kissei: Honoraria; Takeda: Honoraria; Pfizer: Other: Grants or contracts from any entity.; Sanofi: Honoraria.