[An intensive chemotherapy of adult T-cell leukemia/lymphoma]

An intensive combination chemotherapy regimen supported by granulocyte colony-stimulating factor (G-CSF) was evaluated in 81-adult T-cell leukemia/lymphoma (ATLL) patients in a multi-institutional cooperative study. Complete remission and partial remission was achieved in 29 (35.8%) and 31 (38.3%) patients, respectively. The median survival of all patients was 8.5 months with a predicted 3 year survival of 13.5% by the Kaplan-Meier method. The median duration of response was 7.5 months and 13 patients are alive during a maximum observation period of 44.7 months. The median survival time was 29.1 months. Multivariate analysis using the proportional hazards model revealed hypoproteinemia, high GPT and thrombocytopenia as poor prognostic factors. In 42.5% of courses white blood cell (WBC) nadirs were less than 0.5 x 10(9)/l. Days required for the recovery of WBC from the nadir were less than 5 days in 64.2% of the treatment courses. The G-CSF-supported intensified chemotherapy regimen for ATLL yielded a better response rate and longer survival compared to previous reports in Japan. As duration of remission is still short, further studies of postremission therapy or other strategies are warranted.