Meta-analysis on the use of zidovudine and interferon-alfa in adult T-cell leukemia/lymphoma showing improved survival in the leukemic subtypes

Ali Bazarbachi, Yves Plumelle, Juan Carlos Ramos, Patricia Tortevoye, Zaher Otrock, Graham Taylor, Antoine Gessain, William Harrington, Gérard Panelatti, Olivier Hermine

Research output: Contribution to journalArticle

211 Citations (Scopus)

Abstract

Purpose: Human T-cell lymphotropic virus type-I-associated adult T-cell leukemia/lymphoma (ATL) is an aggressive, chemotherapy-resistant malignancy. Multiple small studies using zidovudine (AZT) and interferon-alfa (IFN-α) have shown response in patients with ATL. However, the impact of this innovative antiviral treatment strategy on long-term survival remains undetermined. Patients and Methods: We report a meta-analysis of antiviral therapy of ATL. Medical records of 254 patients with ATL who were treated in the United States, the United Kingdom, Martinique, and continental France were individually reviewed. Results: According to Shimoyama classification, there were 116 patients with acute ATL, 18 patients with chronic ATL, 11 patients with smoldering ATL, and 100 patients with ATL lymphoma. In 231 patients with available survival data, first-line therapy was recorded in 207 patients. Five-year overall survival rates were 46% for 75 patients who received first-line antiviral therapy (P = .004), 20% for 77 patients who received first-line chemotherapy, and 12% for 55 patients who received first-line chemotherapy followed by antiviral therapy. Patients with acute, chronic, and smoldering ATL significantly benefited from first-line antiviral therapy, whereas patients with ATL lymphoma experienced a better outcome with chemotherapy. In acute ATL, achievement of complete remission with antiviral therapy resulted in 82% 5-year survival. Antiviral therapy in chronic and smoldering ATL resulted in 100% 5-year survival. Multivariate analysis confirmed that first-line antiviral therapy significantly improves overall survival of patients with ATL (hazard ratio, 0.47; 95% CI, 0.27 to 0.83; P = .021). Conclusion: These results confirm the high efficacy of AZT and IFN, which should now be considered the gold standard first-line therapy in leukemic subtypes of ATL.

Original languageEnglish
Pages (from-to)4177-4183
Number of pages7
JournalJournal of Clinical Oncology
Volume28
Issue number27
DOIs
StatePublished - Sep 20 2010
Externally publishedYes

Fingerprint

Adult T Cell Leukemia Lymphoma
Zidovudine
Interferon-alpha
Meta-Analysis
Survival
Antiviral Agents
Precursor T-Cell Lymphoblastic Leukemia-Lymphoma
Therapeutics
Drug Therapy
Lymphoma
Martinique
T-Cell Prolymphocytic Leukemia
Human T-lymphotropic virus 1

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

Meta-analysis on the use of zidovudine and interferon-alfa in adult T-cell leukemia/lymphoma showing improved survival in the leukemic subtypes. / Bazarbachi, Ali; Plumelle, Yves; Carlos Ramos, Juan; Tortevoye, Patricia; Otrock, Zaher; Taylor, Graham; Gessain, Antoine; Harrington, William; Panelatti, Gérard; Hermine, Olivier.

In: Journal of Clinical Oncology, Vol. 28, No. 27, 20.09.2010, p. 4177-4183.

Research output: Contribution to journalArticle

Bazarbachi, A, Plumelle, Y, Carlos Ramos, J, Tortevoye, P, Otrock, Z, Taylor, G, Gessain, A, Harrington, W, Panelatti, G & Hermine, O 2010, 'Meta-analysis on the use of zidovudine and interferon-alfa in adult T-cell leukemia/lymphoma showing improved survival in the leukemic subtypes', Journal of Clinical Oncology, vol. 28, no. 27, pp. 4177-4183. https://doi.org/10.1200/JCO.2010.28.0669
Bazarbachi, Ali ; Plumelle, Yves ; Carlos Ramos, Juan ; Tortevoye, Patricia ; Otrock, Zaher ; Taylor, Graham ; Gessain, Antoine ; Harrington, William ; Panelatti, Gérard ; Hermine, Olivier. / Meta-analysis on the use of zidovudine and interferon-alfa in adult T-cell leukemia/lymphoma showing improved survival in the leukemic subtypes. In: Journal of Clinical Oncology. 2010 ; Vol. 28, No. 27. pp. 4177-4183.
@article{d2dec3b42a9b451a88a3511108e3ce1a,
title = "Meta-analysis on the use of zidovudine and interferon-alfa in adult T-cell leukemia/lymphoma showing improved survival in the leukemic subtypes",
abstract = "Purpose: Human T-cell lymphotropic virus type-I-associated adult T-cell leukemia/lymphoma (ATL) is an aggressive, chemotherapy-resistant malignancy. Multiple small studies using zidovudine (AZT) and interferon-alfa (IFN-α) have shown response in patients with ATL. However, the impact of this innovative antiviral treatment strategy on long-term survival remains undetermined. Patients and Methods: We report a meta-analysis of antiviral therapy of ATL. Medical records of 254 patients with ATL who were treated in the United States, the United Kingdom, Martinique, and continental France were individually reviewed. Results: According to Shimoyama classification, there were 116 patients with acute ATL, 18 patients with chronic ATL, 11 patients with smoldering ATL, and 100 patients with ATL lymphoma. In 231 patients with available survival data, first-line therapy was recorded in 207 patients. Five-year overall survival rates were 46{\%} for 75 patients who received first-line antiviral therapy (P = .004), 20{\%} for 77 patients who received first-line chemotherapy, and 12{\%} for 55 patients who received first-line chemotherapy followed by antiviral therapy. Patients with acute, chronic, and smoldering ATL significantly benefited from first-line antiviral therapy, whereas patients with ATL lymphoma experienced a better outcome with chemotherapy. In acute ATL, achievement of complete remission with antiviral therapy resulted in 82{\%} 5-year survival. Antiviral therapy in chronic and smoldering ATL resulted in 100{\%} 5-year survival. Multivariate analysis confirmed that first-line antiviral therapy significantly improves overall survival of patients with ATL (hazard ratio, 0.47; 95{\%} CI, 0.27 to 0.83; P = .021). Conclusion: These results confirm the high efficacy of AZT and IFN, which should now be considered the gold standard first-line therapy in leukemic subtypes of ATL.",
author = "Ali Bazarbachi and Yves Plumelle and {Carlos Ramos}, Juan and Patricia Tortevoye and Zaher Otrock and Graham Taylor and Antoine Gessain and William Harrington and G{\'e}rard Panelatti and Olivier Hermine",
year = "2010",
month = "9",
day = "20",
doi = "10.1200/JCO.2010.28.0669",
language = "English",
volume = "28",
pages = "4177--4183",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "27",

}

TY - JOUR

T1 - Meta-analysis on the use of zidovudine and interferon-alfa in adult T-cell leukemia/lymphoma showing improved survival in the leukemic subtypes

AU - Bazarbachi, Ali

AU - Plumelle, Yves

AU - Carlos Ramos, Juan

AU - Tortevoye, Patricia

AU - Otrock, Zaher

AU - Taylor, Graham

AU - Gessain, Antoine

AU - Harrington, William

AU - Panelatti, Gérard

AU - Hermine, Olivier

PY - 2010/9/20

Y1 - 2010/9/20

N2 - Purpose: Human T-cell lymphotropic virus type-I-associated adult T-cell leukemia/lymphoma (ATL) is an aggressive, chemotherapy-resistant malignancy. Multiple small studies using zidovudine (AZT) and interferon-alfa (IFN-α) have shown response in patients with ATL. However, the impact of this innovative antiviral treatment strategy on long-term survival remains undetermined. Patients and Methods: We report a meta-analysis of antiviral therapy of ATL. Medical records of 254 patients with ATL who were treated in the United States, the United Kingdom, Martinique, and continental France were individually reviewed. Results: According to Shimoyama classification, there were 116 patients with acute ATL, 18 patients with chronic ATL, 11 patients with smoldering ATL, and 100 patients with ATL lymphoma. In 231 patients with available survival data, first-line therapy was recorded in 207 patients. Five-year overall survival rates were 46% for 75 patients who received first-line antiviral therapy (P = .004), 20% for 77 patients who received first-line chemotherapy, and 12% for 55 patients who received first-line chemotherapy followed by antiviral therapy. Patients with acute, chronic, and smoldering ATL significantly benefited from first-line antiviral therapy, whereas patients with ATL lymphoma experienced a better outcome with chemotherapy. In acute ATL, achievement of complete remission with antiviral therapy resulted in 82% 5-year survival. Antiviral therapy in chronic and smoldering ATL resulted in 100% 5-year survival. Multivariate analysis confirmed that first-line antiviral therapy significantly improves overall survival of patients with ATL (hazard ratio, 0.47; 95% CI, 0.27 to 0.83; P = .021). Conclusion: These results confirm the high efficacy of AZT and IFN, which should now be considered the gold standard first-line therapy in leukemic subtypes of ATL.

AB - Purpose: Human T-cell lymphotropic virus type-I-associated adult T-cell leukemia/lymphoma (ATL) is an aggressive, chemotherapy-resistant malignancy. Multiple small studies using zidovudine (AZT) and interferon-alfa (IFN-α) have shown response in patients with ATL. However, the impact of this innovative antiviral treatment strategy on long-term survival remains undetermined. Patients and Methods: We report a meta-analysis of antiviral therapy of ATL. Medical records of 254 patients with ATL who were treated in the United States, the United Kingdom, Martinique, and continental France were individually reviewed. Results: According to Shimoyama classification, there were 116 patients with acute ATL, 18 patients with chronic ATL, 11 patients with smoldering ATL, and 100 patients with ATL lymphoma. In 231 patients with available survival data, first-line therapy was recorded in 207 patients. Five-year overall survival rates were 46% for 75 patients who received first-line antiviral therapy (P = .004), 20% for 77 patients who received first-line chemotherapy, and 12% for 55 patients who received first-line chemotherapy followed by antiviral therapy. Patients with acute, chronic, and smoldering ATL significantly benefited from first-line antiviral therapy, whereas patients with ATL lymphoma experienced a better outcome with chemotherapy. In acute ATL, achievement of complete remission with antiviral therapy resulted in 82% 5-year survival. Antiviral therapy in chronic and smoldering ATL resulted in 100% 5-year survival. Multivariate analysis confirmed that first-line antiviral therapy significantly improves overall survival of patients with ATL (hazard ratio, 0.47; 95% CI, 0.27 to 0.83; P = .021). Conclusion: These results confirm the high efficacy of AZT and IFN, which should now be considered the gold standard first-line therapy in leukemic subtypes of ATL.

UR - http://www.scopus.com/inward/record.url?scp=77957962485&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77957962485&partnerID=8YFLogxK

U2 - 10.1200/JCO.2010.28.0669

DO - 10.1200/JCO.2010.28.0669

M3 - Article

C2 - 20585095

AN - SCOPUS:77957962485

VL - 28

SP - 4177

EP - 4183

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 27

ER -