Journal Article Multicenter Study Ppublish
PubMed: 40716284 DOI: 10.1016/j.canep.2025.102890
Prevalence and survival outcomes of adult T-cell leukemia/lymphoma in Latin America: A multicenter cohort study and recommendations to improve diagnosis and outcomes.
Cancer Epidemiol 98:102890
Authors: Bryan Valcarcel, Henry Idrobo, Astrid Pavlovsky, Eliana C M Miranda, Brady Beltran, Sally Paredes, Daniel Enriquez-Vera, Jule F Vasquez, Claudia Roche, Fabiola Valvert, Luis Villela, Thais Fischer, Juliana Pereira, Renata L R Baptista, Guilherme Duffles, Sergio A B Brasil, Carolina Oliver, Jamila Vaz Tavares, Karin Z Cecyn, Danielle L C De Farias, Rony Schaffel, Frederico Lisboa Nogueira, Fernando Warley, Lorena Fiad, Laura Korin, Patricio H Pereyra, Camila Peña, Macarena Roa, Maria A Torres, Alana Von Glasenapp, Alfredo R Quiroz, Britney N Bell, Raimundo Gazitua, Cesar A Samanez-Figari, Juan P Arriola, Juan L Maradei, Raul H Gabus, Alicia I Enrico, Luciana A Guanchiale, Rosa O Rios-Jiménez, Carmino A De Souza, Thanya Runciman, Irene Tamí-Maury, Denisse Castro-Uriol, Massimo Federico, Carlos Chiattone, Luis Malpica
Affiliations
- Department of Lymphoma and Myeloma, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
- Clinical Central del Eje, Pereira, Colombia; Universidad Tecnologica de Pereira, Pereira, Colombia.
- Buenos Aires Fundaleu, Buenos Aires, Argentina.
- Universidade Estadual de Campinas - UNICAMP, Hemocentro, Sao Paulo, Brazil.
- Instituto de Investigación en Ciencias Biomédicas, Universidad Ricardo Palma, Lima, Peru; Servicio de Oncología Médica, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru.
- Servicio de Oncología Médica, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru; Centro de Investigación de Medicina de Precisión, Universidad de San Martin de Porres, Lima, Perú.
- Joint Research Center for Human Retrovirus Infection, Kagoshima University, Kagoshima, Japan.
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru.
- Hospital Arnaldo Milián Castro, Villa Clara, Cuba.
- Instituto de Cancerologia, Liga Nacional Contra el Cancer, Guatemala, Guatemala.
- Universidad Autónoma de Sinaloa, Facultad de Medicina, Sinaloa, Mexico; Hospital Fernando Ocaranza ISSSTE, Centro Medico Dr. Ignacio Chavez ISSSTESON, Sonora, Mexico.
- AC Camargo Cancer Center, Sao Paulo, AC, Brazil.
- University of Sao Paulo, Department of Hematology, Hemotherapy & Cell Therapy, Sao Paulo, Brazil.
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
- Santa Casa Medical School, Sao Paulo, Brazil.
- Hospital Británico, Casmu, Montevideo, Uruguay.
- Ophir Loyola Hospital, Belém, Brazil.
- Federal University of Sao Paulo, Sao Paulo, Brazil.
- Hospital Beneficencia Portuguesa, Sao Paulo, Brazil.
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
- Hospital Luxemburgo, Instituto Mário Penna, Belo Horizonte, Brazil.
- Hospital Italiano, Buenos Aires, Argentina.
- Hospital Italiano La Plata, La Plata, Buenos Aires, Argentina.
- CABA, Alexander Fleming Institute, Olivos, Argentina.
- Hospital Nacional A. Posadas, Buenos Aires, Argentina.
- Hospital Del Salvador, Santiago, Chile.
- Clinica Santa Sofia, Caracas, Venezuela.
- Hospital Central IPS, Asuncion, Paraguay.
- Boston University Chobanian & Avedisian School of Medicine. Boston University Center for Forced Displacement, Boston, USA.
- Instituto Oncologico Fundacion Arturo Lopez Perez, Santiago, Chile.
- AUNA Oncosalud, Lima, Peru.
- Hospital Marie Curie, Buenos Aires, Argentina.
- Hospital Emilio Ferreyra, Necochea, Argentina.
- Hospital Maciel, Montevideo, Uruguay.
- Hospital Gutierrez, La Plata, Argentina.
- Hospital Privado Universitario de Cordoba, Argentina.
- Sociedad Cubana de Hematologia, La Habana, Cuba.
- Departamento de Oncología y Radioterapia, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru.
- University of Texas Health Science Center at Houston, Houston, TX, USA.
- Servicio de Oncología Médica, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru; Centro de Investigación de Medicina de Precisión, Universidad de San Martin de Porres, Lima, Perú.
- University of Modena and Reggio Emilia, Modena, Italy.
- Santa Casa Medical School, Sao Paulo, Brazil; Samaritano Hospital, Sao Paulo, Brazil.
Abstract
BACKGROUND
Although adult T-cell leukemia/lymphoma (ATL) has a higher burden in Latin America compared to North American or European countries, few studies have described the outcomes of this disease. We estimated the hospital-based prevalence and overall survival (OS) of ATL.
METHODS
We conducted a cohort study among patients aged ≥ 18 years with pathologically diagnosed mature T-cell lymphoma across 11 Latin American countries from 2000 to 2023 by pooling data from 3 hospital-based registries. We used the Kaplan-Meier method to estimate survival outcomes.
RESULTS
Among 1963 patients with mature T-cell lymphoma, the pooled prevalence of ATL was 17 % (n = 329; 95 % confidence interval [CI]=15-18 %), with the highest observed in Peru (n = 158; 38 %, 95 % CI=33-43 %) and Colombia (n = 17; 29 %, 95 % CI=18-41 %). Over time, ATL cases only increased significantly in Peru, from 14 % in 2000-2004 to 58 % in 2019-2023 (P trend<0.001). With a median follow-up of 37 months (95 % CI=30-54 months), the 3-year OS of ATL was 25 % (95 % CI=20-32 %), and the median OS was 9 months (95 % CI=8-12 months). OS did not differ across countries (range 19-47 %, P = 0.210). Patients with lymphomatous ATL had worse outcomes than those with PTCL-NOS only in Peru (P heterogeneity=0.029).
CONCLUSION
Our findings indicate a higher ATL prevalence in Latin America than previously reported in North America or Europe, likely due to differences in HTLV-1 endemicity and diagnostic practices. The similar and poor survival rates across countries underscore the need for targeted interventions to improve patient outcomes. We propose expert-based research priorities and suggest further epidemiological validation studies.
MeSH
Cells, Leukemia-Lymphoma, Adult T-Cell, Lymphoma, Cohort Studies, Leukemia, Leukemia, T-Cell, Prevalence, Diagnosis, T-Lymphocytes