Survival analysis, and racial and gender disparities in adult T-cell leukemia/lymphoma: A population based retrospective study.

Abstract

e22571 Background: Adult T cell leukemia/lymphoma (ATLL) is a rare and aggressive T cell malignancy, associated with human T cell lymphotropic virus 1 (HTLV-1). The risk of developing lymphoma in carriers of HTLV-1 is estimated to be 2-5%. The purpose of this study is to identify racial and gender distribution, and survival trends based on recent data from SEER stat database. Methods: ATLL cases were collected from Surveillance, Epidemiology and End Result database Research Plus Data, 17 Registries, Nov 2023 Sub (2000-2021), using the ICD Code 9827/3. The data was stratified based on age, sex, race, primary site labelled, stage, median household income inflation adjusted to 2022, and various treatment types. Survival curves were compared using the Log-Rank test (GraphPad Prism). Results: Total 656 cases of ATLL were identified, of which 50.91% were males. The neoplasm was most seen in Caucasians (43.6%) followed by Black (32.77%), Hispanic (12.04%), Asian/Pacific Islander (9.91%), American Indian/Alaskan (0.76%), and unknown race (0.91%). The median age of diagnosis was 61 years, and median time from diagnosis to treatment was 9 days. 84.76% of the identified patients had a median household income less than $100,000. Overall median of survival (MoS) was 11 months, with a 1-year OS of 47% (CI 95%, 43-51%), 3-year OS of 31.7% (CI 95%, 28-35.5%), and 5-year OS of 27% (CI 95%, 23.6-31%). The MoS based on age showed a decline in survival with advancing age (p < 0.0001). Survival based on race revealed Alaskan/AI (34 months) followed by White (18 months), Hispanic (16 months), Black (7 months), and Asian/PI (6.5 months) (p 0.0043). Survival analysis revealed 10 months for neoplasm confined to blood and bone marrow, and 13 months for non-hematopoietic disease (p 0.0036). Analysis was insignificant for gender, stage, income as well as treatments with chemotherapy and radiation therapy. Conclusions: Adult T cell Leukemia/Lymphoma is rare malignancy, with a high prevalence in low socioeconomic background, a slight predilection for Caucasian race. Overall higher survival was associated with young age, Alaskan/AI and Caucasian origin and disease involving non-hematopoietic tissues. Survival was independent of gender, stage, median household income or treatment with chemo-radiation therapy. Our study has some limitations as we were not able to access information regarding different variants of the disease rendering it difficult to do clinical variant based survival. More research and analysis are required to compare survival based on clinical variants and chemotherapy versus antiviral treatment.