RESUMO
Okinawa Prefecture, located in the subtropics, is an area of endemic adult T-cell leukemia-lymphoma (ATL) in Japan. We retrospectively analyzed 659 patients with aggressive ATL in seven institutions in Okinawa between 2002 and 2011. The median patient age was 68 years. More patients were aged ≥90 years (2.6 %), in this study, than in a nationwide survey (<1 %). The median survival time (MST) of the entire cohort was 6.5 months. Of the 217 patients who had a clinical status similar to that stated in the eligibility criteria of JCOG9801 (a randomized phase III study comparing VCAP-AMP-VECP with CHOP-14), 147 who received the CHOP regimen had a poorer MST than those in the CHOP-14 arm of JCOG9801 (8 vs 11 months). The prevalence of strongyloidiasis in the ATL patients was much higher (12.4 %) than in the historical cohort who visited the University of the Ryukyus Hospital (3.4 %). Furthermore, strongyloidiasis may be associated with ATL-related deaths. These findings suggest that, compared with other areas in Japan, in Okinawa, the proportion of patients aged ≥90 years with clinical features of aggressive ATL is higher, outcomes are poorer, and the disease is associated with a higher prevalence of strongyloidiasis.
Assuntos
Leucemia-Linfoma de Células T do Adulto/epidemiologia , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Estudos de Coortes , Ciclofosfamida/uso terapêutico , Doxorrubicina/uso terapêutico , Humanos , Japão/epidemiologia , Leucemia-Linfoma de Células T do Adulto/complicações , Leucemia-Linfoma de Células T do Adulto/tratamento farmacológico , Leucemia-Linfoma de Células T do Adulto/parasitologia , Prednisona/uso terapêutico , Estudos Retrospectivos , Estrongiloidíase/etiologia , Vincristina/uso terapêuticoRESUMO
A 61-year-old man, who was diagnosed with Bence-Jones protein (BJP)-λ type multiple myeloma, was treated with bortezomib. Although maintenance therapy including lenalidomide was continued, t(9;22)(q34;q11.2) was detected in the marrow cells by a cytogenetic study. The increased incidence of a secondary malignancy after treatment with lenalidomide for multiple myeloma has been highlighted in previous clinical trials; however, reports on the presence of t(9;22)(q34;q11.2) or the onset of chronic myelogenous leukemia have yet to be found. Although the cause of chronic myelogenous leukemia with the lenalidomide treatment is not yet clear, it is an interesting case.
