Disaggregating aggressive ATLL: A retrospective Study focused on the lymphomatous variant in Latin America
Year: 2025
Type: conference-abstract
Abstract: Background: The different subtypes of ATLL, as per the Shimoyama classification, are consistently described as distinct diseases in terms of their clinical features, outcomes, and even distinctive molecular patterns. However, it is common to analyze the aggressive ATLL types (acute and lymphoma type) together, which can obscure the unique clinical and biological characteristics of each subtype thereby making it more challenging to understand this complex and difficult-to-treat disease. The objective of this study is to describe a cohort of patients with the lymphomatous type of ATLL in Latin America. Methods: We conducted a cohort study among patients ≥18 years with newly diagnosed ATLL and selected all lymphoma type from T-cell Brazil Project (TCBP, Ambispective, Clinicaltrials.gov ID= NCT03207789, 2015-2025, n= 51) and the Grupo de Estudio Latinoamericano de Linfoproliferativos (GELL, Retrospective, 2000-2023, n= 126). Clinical and biological data at diagnosis were collected, along with information on treatment, response, and follow-up. The Kaplan-Meier method was used to estimate survival, while the Log-Rank test was applied to compare the curves. Additionally, Cox regression models were used to identify prognostic factors for OS and EFS, with a significance level of 5%. Results: This analysis included a total of 177 cases, comprising 100 from Peru, 51 from Brazil, 13 from Chile, 7 from Argentina, and 6 from Colombia. The median age was 54 years (20-95), with 50.6% male, 83% having advanced disease (Ann Arbor stage III-IV), 44% with extra-nodal involvement, 61% having an IPI score of 3-5, and 59% having a PIT score of 2-4. The treatment was likely curative in almost 97% (72% chemotherapy (CT) alone, 18% CT + AZT and INF, 7% AZT + INF). CHOP-like was the most used (44% CHOP and 29% CHOEP). 28% had a complete response after 1st line therapy and 39% no response/progression. Only 5 (3%) received transplantation as consolidation, and 68% had progression/relapse. The median follow-up duration of the survivors was 14 months (1-182). 24-month OS was 28% and 18% for EFS. The final Cox model for OS was median age ≥ 54y (HR 2.35 95%CI 1.55-3.57, p< 0.0001), ECOG ≥2 (HR 1.90 95%CI 1.22-2.97, p=0.005), higher LDH (HR 2.77, 95%CI 1.50-5.10, p=0-.001) and B symptoms (HR 2.65, 95%CI 1.61-4.37, p<0.0001), and for EFS the final model was compound with the same prognosis factors.Conclusion: To our knowledge, this study represents the largest cohort of the ATLL lymphoma subtype in Latin America and suggests that OS and EFS for this malignancy remains poor, primarily due to advanced stage at diagnosis, high-risk clinical features, and limited access to adequate therapy. These findings underscore the need for a richer understanding of the condition to enable appropriate risk stratification and guide clinical trials exploring newer therapeutic approaches.
Source: Blood
Authors: Maria Dias, Bryan Valcarcel, Denisse Castro, Brady Beltran, Daniel Enriquez, Jule Vasquez, Yung Gonzaga, Eliana Miranda, Macarena Roa, Fernando Warley, Nancy Fiad, Laura Korin, Patricio Pereyra, Henry Quintero, Renata Baptista, Juliana Pereira, Thais Fischer, Carmino De Souza, Luis Malpica, Carlos Chiattone
Institutions: Universidade Federal da Bahia, The University of Texas MD Anderson Cancer Center, Hospital Nacional Edgardo Rebagliati Martins, Universidad Ricardo Palma, Instituto Nacional de Enfermedades Neoplásicas, Instituto Nacional de Câncer - INCA, Universidade Estadual de Campinas (UNICAMP), Hospital del Salvador, Hospital Italiano de Buenos Aires, Universidad Hospital Italiano, Hospital Italiano La Plata, Instituto Alexander Fleming, Universidade do Estado do Rio de Janeiro, Universidade de São Paulo, AC Camargo Hospital, Hospital Samaritano de São Paulo
Language: English
Subfield: Immunology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: bronze
OpenAlex ID: W4417004316
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