Prevalence and survival outcomes of adult T-cell leukemia/lymphoma in Latin America: A multicenter cohort study and recommendations to improve diagnosis and outcomes.
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Valcarcel Bryan, Idrobo Henry, Pavlovsky Astrid, Miranda Eliana C M, Beltran Brady, Paredes Sally, Enriquez-Vera Daniel, Vasquez Jule F, Roche Claudia, Valvert Fabiola, Villela Luis, Fischer Thais, Pereira Juliana, Baptista Renata L R, Duffles Guilherme, Brasil Sergio A B, Oliver Carolina, Tavares Jamila Vaz, Cecyn Karin Z, De Farias Danielle L C, Schaffel Rony, Nogueira Frederico Lisboa, Warley Fernando, Fiad Lorena, Korin Laura, Pereyra Patricio H, Peña Camila, Roa Macarena, Torres Maria A, Von Glasenapp Alana, Quiroz Alfredo R, Bell Britney N, Gazitua Raimundo, Samanez-Figari Cesar A, Arriola Juan P, Maradei Juan L, Gabus Raul H, Enrico Alicia I, Guanchiale Luciana A, Rios-Jiménez Rosa O, De Souza Carmino A, Runciman Thanya, Tamí-Maury Irene, Castro-Uriol Denisse, Federico Massimo, Chiattone Carlos, Malpica Luis
Аннотация
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 (Ptrend<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 (Pheterogeneity=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.