Table 1 Treatment responses to radiation... | American Society of Hematology

Table 1

Treatment responses to radiation therapy according to ATL lesion type

Patient	ATL subtype	Prior systemic therapy	RT site	Lesion type	RT source	RT energy	Total dose, Gy	Frac-tion dose, Gy	Initial local response	In-field relapse	Out-of-field relapse	Additional therapy after RT	Time from RT to last evaluation, mo	Disease at last evaluation
1	Acute	CHOP	Lt neck, Bl supraclav	Nodal	Photon	6/15 MV	30	3	PR	No	Yes	Fludarabine/ cyclophosphamide/ LMB-2	2.4	Local* + distant
2	Lymphomatous	Alemtuzumab	Rt groin	Nodal	Electron	6 MeV	24	2	CR	No	Yes†	CHOP/denileukin diftitox	16.7	Distant*
3	Smoldering	Daclizumab, alemtuzumab	Rt scapula	Cutaneous	Electron	9 MeV	36	3	PR	No	Yes†	Alemtuzumab, etoposide	42.0	Local + distant
4	Acute	CHOP, fludarabine/ cyclophosphamide/LMB-2, denileukin diftitox	Lt pelvic mass	Nodal	Photon	15 MV	20	2	CR	No	Yes†	EPOCH/fludarabine, allo-transplant, intrathecal methotrexate, EPOCH/fludarabine	10.0	Local + distant
5	Acute	EPOCH/alemtuzumab, intrathecal methotrexate, fludarabine/cyclophosphamide/LMB-2	Rt groin	Cutaneous	Photon	6 MV	30	3	PR	No	Yes	No	1.6	Local* + distant
			Rt ankle	Cutaneous	Photon	6 MV	30	3	PR	No
			Lt orbit	Extra-nodal	Photon	6 MV	15	3	PR	No
6	Smoldering	EPOCH/rituximab/siplizumab, 7-hydroxystaurosporine, denileukin diftitox, nelfinavir/ alemtuzumab	Forehead	Cutaneous	Electron	6 MeV	50	2	CR	No	Yes†	No	15.8	Local + distant
			Lt lower extremity	Cutaneous	Electron	6 MeV	50	2	CR	No
			Rt lower extremity	Cutaneous	Photon	6 MV	50	2	PR	No
			Lt ankle	Cutaneous	Photon	6 MV	60	2	CR	No
			Lt nares, malar eminence	Cutaneous	Electron	9 MeV	60	2	PR	No
			Submental chin	Cutaneous	Electron	6 MeV	50	2	CR	No
			Rt Achilles heel	Cutaneous	Photon	6 MV	50	2	CR	No
7‡	Acute	CHOP, denileukin diftitox	Bl neck	Nodal	Photon	6/15 MV	50	2	PR	No	No	No	0.3	Local
8	Acute	EPOCH/rituximab, denileukin diftitox, alemtuzumab	Lt neck, supraclav	Nodal	Photon	6 MV	12	3	PR	No	Yes	No	0.1	Local* + distant
			Rt head/neck	Nodal	Electron	9 MeV	12	3	CR	No
9	Acute	CHOP, alemtuzumab/ deoxycoformycin, intrathecal methotrexate	Whole brain	Lepto-meningeal	Photon	6 MV	30	3	PR	No	Yes	No	0.4	Local* + distant
10	Acute	CHOP, EPOCH, yttrium-90 daclizumab	T-spine	Nodal	Photon	15 MV	24	2	PR	No	Yes	No	0.3	Local* + distant
			C-spine	Nodal	Photon	6 MV	24	2	PR	No

Patient	ATL subtype	Prior systemic therapy	RT site	Lesion type	RT source	RT energy	Total dose, Gy	Frac-tion dose, Gy	Initial local response	In-field relapse	Out-of-field relapse	Additional therapy after RT	Time from RT to last evaluation, mo	Disease at last evaluation
1	Acute	CHOP	Lt neck, Bl supraclav	Nodal	Photon	6/15 MV	30	3	PR	No	Yes	Fludarabine/ cyclophosphamide/ LMB-2	2.4	Local* + distant
2	Lymphomatous	Alemtuzumab	Rt groin	Nodal	Electron	6 MeV	24	2	CR	No	Yes†	CHOP/denileukin diftitox	16.7	Distant*
3	Smoldering	Daclizumab, alemtuzumab	Rt scapula	Cutaneous	Electron	9 MeV	36	3	PR	No	Yes†	Alemtuzumab, etoposide	42.0	Local + distant
4	Acute	CHOP, fludarabine/ cyclophosphamide/LMB-2, denileukin diftitox	Lt pelvic mass	Nodal	Photon	15 MV	20	2	CR	No	Yes†	EPOCH/fludarabine, allo-transplant, intrathecal methotrexate, EPOCH/fludarabine	10.0	Local + distant
5	Acute	EPOCH/alemtuzumab, intrathecal methotrexate, fludarabine/cyclophosphamide/LMB-2	Rt groin	Cutaneous	Photon	6 MV	30	3	PR	No	Yes	No	1.6	Local* + distant
			Rt ankle	Cutaneous	Photon	6 MV	30	3	PR	No
			Lt orbit	Extra-nodal	Photon	6 MV	15	3	PR	No
6	Smoldering	EPOCH/rituximab/siplizumab, 7-hydroxystaurosporine, denileukin diftitox, nelfinavir/ alemtuzumab	Forehead	Cutaneous	Electron	6 MeV	50	2	CR	No	Yes†	No	15.8	Local + distant
			Lt lower extremity	Cutaneous	Electron	6 MeV	50	2	CR	No
			Rt lower extremity	Cutaneous	Photon	6 MV	50	2	PR	No
			Lt ankle	Cutaneous	Photon	6 MV	60	2	CR	No
			Lt nares, malar eminence	Cutaneous	Electron	9 MeV	60	2	PR	No
			Submental chin	Cutaneous	Electron	6 MeV	50	2	CR	No
			Rt Achilles heel	Cutaneous	Photon	6 MV	50	2	CR	No
7‡	Acute	CHOP, denileukin diftitox	Bl neck	Nodal	Photon	6/15 MV	50	2	PR	No	No	No	0.3	Local
8	Acute	EPOCH/rituximab, denileukin diftitox, alemtuzumab	Lt neck, supraclav	Nodal	Photon	6 MV	12	3	PR	No	Yes	No	0.1	Local* + distant
			Rt head/neck	Nodal	Electron	9 MeV	12	3	CR	No
9	Acute	CHOP, alemtuzumab/ deoxycoformycin, intrathecal methotrexate	Whole brain	Lepto-meningeal	Photon	6 MV	30	3	PR	No	Yes	No	0.4	Local* + distant
10	Acute	CHOP, EPOCH, yttrium-90 daclizumab	T-spine	Nodal	Photon	15 MV	24	2	PR	No	Yes	No	0.3	Local* + distant
			C-spine	Nodal	Photon	6 MV	24	2	PR	No

RT indicates radiation therapy; CHOP, cyclophosphamide, doxorubicin, vincristine, prednisolone; Lt, left; Bl, bilateral; PR, partial response; Rt, right; CR, complete response; and EPOCH, etoposide, doxorubicin, vincristine, cyclophosphamide, prednisone.

Disease status at the time of patient mortality.

†

Patients with new out-of-field disease, as opposed to patients with out-of-field progression of disease that was evident before starting radiation therapy. The times from the completion of radiation therapy to the identification of new out-of field disease in these patients were as follows: patient 2, 9.7 mo; patient 3, 13.8 mo; patient 4, 0.9 mo; and patient 6, 1.9 mo (mean, 6.6 mo).

‡

This male patient was from Haiti. The remaining 9 patients were women from Jamaica.

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