文章：

日本成人T细胞白血病/淋巴瘤死亡率下降趋势与异体造血干细胞移植之间的关系：日本生命统计和日本造血细胞移植学会（JSHCT）分析

Association between decreasing trend in the mortality of adult T-cell leukemia/lymphoma and allogeneic hematopoietic stem cell transplants in Japan: analysis of Japanese vital statistics and Japan Society for Hematopoietic Cell Transplantation (JSHCT)

原文发布日期：2013-11-15

DOI: 10.1038/bcj.2013.57

类型: Original Article

开放获取: 是

英文摘要：

Adult T-cell leukemia/lymphoma (ATLL) is a peripheral T-cell neoplasm with a very poor outcome. However, several studies have shown a progress in the treatment. To evaluate the effect of the progress in the treatment of ATLL in a whole patient population, we used vital statistics data and estimated age-adjusted mortality and trends in the mortality from 1995 to 2009. Since allogeneic hematopoietic stem-cell transplantation (allo-HSCT) has been introduced as a modality with curative potential during study period, we also evaluated the association of the annual number of allo-HSCT and the trend of the mortality of ATLL. Endemic (Kyushu) and non-endemic areas (others) were evaluated separately. Significance in the trend of mortality was evaluated by joinpoint regression analysis. During the study period, a total of 14 932 patients died of ATLL in Japan, and mortality decreased significantly in both areas (annual percent change (95% confidence interval (CI)): Kyushu, −3.1% (−4.3, −1.9); others, −3.4% (−5.3, −1.5)). This decreasing trend in mortality seems to be associated with an increase in the number of allo-HSCTs (Kyushu, R-squared=0.70, P=0.003; and others, R-squared=0.55, P=0.058). This study reveals that the mortality of ATLL is now significantly decreasing in Japan and this decreasing trend might be associated with allo-HSCT.

摘要翻译： 

成人T细胞白血病/淋巴瘤（ATLL）是一种预后极差的外周T细胞肿瘤。然而，多项研究显示其治疗已取得进展。为评估ATLL治疗进展对整体患者群体的影响，我们利用生命统计资料，估算了1995年至2009年经年龄调整后的死亡率及其变化趋势。在研究期间，由于异基因造血干细胞移植（allo-HSCT）已被引入作为具有治愈潜力的治疗方式，我们还评估了年度allo-HSCT实施数量与ATLL死亡率变化趋势的关联性。研究分别对流行区（九州）和非流行区（其他地区）进行了评估。通过连接点回归分析评估死亡率趋势的显著性。研究期间，日本共有14,932例患者死于ATLL，两个地区的死亡率均显著下降（年度变化百分比（95%置信区间）：九州地区-3.1%（-4.3至-1.9）；其他地区-3.4%（-5.3至-1.5）。这种死亡率下降趋势似乎与allo-HSCT数量的增加相关（九州地区R平方=0.70，P=0.003；其他地区R平方=0.55，P=0.058）。本研究揭示，日本ATLL死亡率目前正显著下降，且这种下降趋势可能与异基因造血干细胞移植的应用相关。

原文链接：

Association between decreasing trend in the mortality of adult T-cell leukemia/lymphoma and allogeneic hematopoietic stem cell transplants in Japan: analysis of Japanese vital statistics and Japan Society for Hematopoietic Cell Transplantation (JSHCT)