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Adult T cell leukemia-lymphoma (ATL) is clinically heterogeneous and is classified into four subtypes: acute, lymphoma, chronic, and smoldering. Recently, a new prognostic index based on the value of soluble interleukin-2 receptor, denoted the "iATL-PI," has been proposed for patients with smoldering and chronic ATL. To evaluate the effectiveness of the iATL-PI, we re-analyzed our previously published data on 176 patients with smoldering or chronic ATL (76 smoldering, 100 chronic) diagnosed between 2010 and 2011, as well data from the subsequent follow-up study on prognosis between 2016 and 2017. The proportions for the low-, intermediate-, and high-risk iATL-PI groups at the time of ATL diagnosis were 44.7%, 48.7%, and 5% for smoldering ATL; 6.3%, 71.9%, and 21.9% for favorable chronic ATL; and 5.9%, 27.9%, and 66.2% for unfavorable chronic ATL, respectively. The survival of patients with smoldering or chronic ATL as a whole was significantly stratified according to the three iATL-PI groups. Most patients with unfavorable chronic ATL in the low iATL-PI risk group had indolent clinical courses. Our results showed that iATL may become a useful tool to predict the prognosis of smoldering and chronic ATL, which have diverse clinical courses. © 2022. Japanese Society of Hematology.


Yoshitaka Imaizumi, Masako Iwanaga, Kisato Nosaka, Kenji Ishitsuka, Kenichi Ishizawa, Shigeki Ito, Masahiro Amano, Takashi Ishida, Naokuni Uike, Atae Utsunomiya, Koichi Ohshima, Junji Tanaka, Yoshiki Tokura, Kensei Tobinai, Toshiki Watanabe, Kaoru Uchimaru, Kunihiro Tsukasaki. Validation of the iATL-PI prognostic index in therapeutic decision-making for patients with smoldering and chronic ATL: a multicenter study. International journal of hematology. 2023 Feb;117(2):206-215

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PMID: 36308678

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