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VCAP-AMP-VECP as a preferable induction chemotherapy in transplant-eligible patients with aggressive adult T-cell leukemia-lymphoma: a propensity score analysis

Bone Marrow Transplantation volume 54, pages 1399–1405 (2019)Cite this article

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Abstract

A dose-intensified multi-agent chemotherapy regimen called VCAP-AMP-VECP was investigated in Japan as front-line therapy for patients with adult T-cell leukemia-lymphoma (ATL). Although a prospective randomized controlled study showed that VCAP-AMP-VECP was superior to CHOP, the trial was rather small and no subsequent studies confirmed the benefit of VCAP-AMP-VECP over CHOP. We conducted a retrospective analysis of transplant-eligible patients with ATL who received only VCAP-AMP-VECP or CHOP, incorporating inverse probability of treatment weighting (IPTW) using propensity scoring. Overall, 947 and 513 patients were treated with VCAP-AMP-VECP and CHOP, respectively. The median follow-up of surviving patients was 1006 days. The crude probabilities of 2-year overall survival (OS) for patients in the VCAP-AMP-VECP and CHOP groups were 31.2% and 24.6%, respectively (P < 0.001). Stratified by risk group according to the modified ATL-prognostic index score at diagnosis, the crude probabilities of 2-year OS in the VCAP-AMP-VECP and CHOP groups were 39.8 and 45.0% in the low-risk group (P = 0.69), 32.2 and 21.6% in the intermediate-risk group (P < 0.001), and 17.2 and 6.2% in the high-risk group (P = 0.005). Our current analysis suggests that VCAP-AMP-VECP regimen is a preferable front-line therapy in patients with aggressive ATL in intermediate- and high-risk groups.

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Acknowledgements

Authors contributions

S.F., T.Y., Y.I., and T.F. participated in research design, data analysis, and manuscript writing. A.U., Y.M., S.O., T.M., Y.S., E.O., and S.Y. gathered the data. All authors approved the submission of this manuscript.

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Authors and Affiliations

  1. Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan

    Shigeo Fuji, Yoshitaka Inoue & Takahiro Fukuda

  2. Department of Hematology, Osaka International Cancer Institute, Osaka, Japan

    Shigeo Fuji

  3. Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan

    Takuhiro Yamaguchi

  4. Department of Hematology, Kumamoto University Hospital, Kumamoto, Japan

    Yoshitaka Inoue

  5. Department of Hematology, Imamura General Hospital, Kagoshima, Japan

    Atae Utsunomiya

  6. Department of Hematology, Sasebo City General Hospital, Sasebo, Japan

    Yukiyoshi Moriuchi

  7. Department of Hematology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan

    Satsuki Owatari

  8. Department of Hematology, Heart-Life Hospital, Okinawa, Japan

    Takashi Miyagi

  9. Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan

    Yasushi Sawayama

  10. Department of Hematology, Oita Prefectural Hospital, Oita, Japan

    Eiichi Otsuka

  11. Department of Hematology, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan

    Shin-ichiro Yoshida

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  1. Shigeo Fuji
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  11. Takahiro Fukuda
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Correspondence to Shigeo Fuji.

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Conflict of interest

S.F. received honoraria from the Kyowa Hakko Kirin Co., Ltd.; T.Y. had ownership interests of Statcom Co., Ltd., received consulting fees from Ono Pharmaceutical Co., Ltd., honoraria from Taiho Pharmaceutical Co., Ltd., and research funding from Kyowa Hakko Kirin Co., Ltd.; and A.U. received honoraria from Kyowa Hakko Kirin, Daiichi Sankyo, Siemens, Bristol-Myers Squibb, Pfizer, Novartis Pharma, Nippon Shinyaku, Mundi Pharma, Chugai Pharma, Ono Pharmaceutical CO, Eisai, Celgene, JIMRO, and Otsuka Pharmaceutical.

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Fuji, S., Yamaguchi, T., Inoue, Y. et al. VCAP-AMP-VECP as a preferable induction chemotherapy in transplant-eligible patients with aggressive adult T-cell leukemia-lymphoma: a propensity score analysis. Bone Marrow Transplant 54, 1399–1405 (2019). https://doi.org/10.1038/s41409-019-0446-z

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