{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T23:44:42Z","timestamp":1785887082294,"version":"3.56.0"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":65,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP25ck0106860h0003"],"award-info":[{"award-number":["JP25ck0106860h0003"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP25fk0108672h0003"],"award-info":[{"award-number":["JP25fk0108672h0003"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP26ck0106860h0004"],"award-info":[{"award-number":["JP26ck0106860h0004"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP26fk0108759"],"award-info":[{"award-number":["JP26fk0108759"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP25fk0108671s1003"],"award-info":[{"award-number":["JP25fk0108671s1003"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP26fk0108738s0301"],"award-info":[{"award-number":["JP26fk0108738s0301"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP26fk0108733s0602"],"award-info":[{"award-number":["JP26fk0108733s0602"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP26ck0106860h0004"],"award-info":[{"award-number":["JP26ck0106860h0004"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"MEXT | Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["25K19568"],"award-info":[{"award-number":["25K19568"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Blood Cancer J."],"DOI":"10.1038\/s41408-026-01534-7","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T11:16:10Z","timestamp":1780312570000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic impact of morphological lymphocyte counts on aggressive adult T-cell leukemia\/lymphoma: Japan ATL nationwide registry analysis"],"prefix":"10.1038","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2031-7385","authenticated-orcid":false,"given":"Koji","family":"Jimbo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayumu","family":"Ito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7830-5281","authenticated-orcid":false,"given":"Erika","family":"Horibe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoko","family":"Yagishita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junya","family":"Makiyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidehiro","family":"Itonaga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayoshi","family":"Miyazono","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kisato","family":"Nosaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5935-0385","authenticated-orcid":false,"given":"Makoto","family":"Yoshimitsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilseung","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriaki","family":"Kawano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ki-Ryang","family":"Koh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eiichi","family":"Otsuka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidetoshi","family":"Nakashima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7527-0345","authenticated-orcid":false,"given":"Yoshihisa","family":"Yamano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhito","family":"Nannya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Fukuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the Japan Aggressive ATL Consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"key":"1534_CR1","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1182\/blood.V50.3.481.481","volume":"50","author":"T Uchiyama","year":"1977","unstructured":"Uchiyama T, Yodoi J, Sagawa K, Takatsuki K, Uchino H. Adult T-cell leukemia: clinical and hematologic features of 16 cases. Blood. 1977;50:481\u201392.","journal-title":"Blood"},{"key":"1534_CR2","doi-asserted-by":"publisher","first-page":"7415","DOI":"10.1073\/pnas.77.12.7415","volume":"77","author":"BJ Poiesz","year":"1980","unstructured":"Poiesz BJ, Ruscetti FW, Gazdar AF, Bunn PA, Minna JD, Gallo RC. Detection and isolation of type C retrovirus particles from fresh and cultured lymphocytes of a patient with cutaneous T-cell lymphoma. Proc Natl Acad Sci USA. 1980;77:7415\u20139.","journal-title":"Proc Natl Acad Sci USA"},{"key":"1534_CR3","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1038\/294268a0","volume":"294","author":"BJ Poiesz","year":"1981","unstructured":"Poiesz BJ, Ruscetti FW, Reitz MS, Kalyanaraman VS, Gallo RC. Isolation of a new type C retrovirus (HTLV) in primary uncultured cells of a patient with S\u00e9zary T-cell leukaemia. Nature. 1981;294:268\u201371.","journal-title":"Nature"},{"key":"1534_CR4","doi-asserted-by":"publisher","first-page":"2031","DOI":"10.1073\/pnas.79.6.2031","volume":"79","author":"M Yoshida","year":"1982","unstructured":"Yoshida M, Miyoshi I, Hinuma Y. Isolation and characterization of retrovirus from cell lines of human adult T-cell leukemia and its implication in the disease. Proc Natl Acad Sci USA. 1982;79:2031\u20135.","journal-title":"Proc Natl Acad Sci USA"},{"key":"1534_CR5","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1111\/j.1365-2141.1991.tb08051.x","volume":"79","author":"M Shimoyama","year":"1991","unstructured":"Shimoyama M. Diagnostic criteria and classification of clinical subtypes of adult T-cell leukaemia-lymphoma. A report from the Lymphoma Study Group (1984-87). Br J Haematol. 1991;79:428\u201337.","journal-title":"Br J Haematol"},{"key":"1534_CR6","doi-asserted-by":"publisher","first-page":"677","DOI":"10.1200\/JCO.18.00501","volume":"37","author":"LB Cook","year":"2019","unstructured":"Cook LB, Fuji S, Hermine O, Bazarbachi A, Ramos JC, Ratner L, et al. Revised adult T-cell leukemia-lymphoma international consensus meeting report. J Clin Oncol. 2019;37:677.","journal-title":"J Clin Oncol"},{"key":"1534_CR7","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1182\/blood.2019004045","volume":"137","author":"LB Cook","year":"2021","unstructured":"Cook LB, Phillips AA. How I treat adult T-cell leukemia\/lymphoma. Blood. 2021;137:459\u201370.","journal-title":"Blood"},{"key":"1534_CR8","doi-asserted-by":"publisher","first-page":"1635","DOI":"10.1200\/JCO.2011.38.2101","volume":"30","author":"H Katsuya","year":"2012","unstructured":"Katsuya H, Yamanaka T, Ishitsuka K, Utsunomiya A, Sasaki H, Hanada S, et al. Prognostic index for acute- and lymphoma-type adult T-cell leukemia\/lymphoma. J Clin Oncol. 2012;30:1635\u201340.","journal-title":"J Clin Oncol"},{"key":"1534_CR9","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1111\/bjh.12962","volume":"166","author":"T Fukushima","year":"2014","unstructured":"Fukushima T, Nomura S, Shimoyama M, Shibata T, Imaizumi Y, Moriuchi Y, et al. Japan Clinical Oncology Group (JCOG) prognostic index and characterization of long-term survivors of aggressive adult T-cell leukaemia-lymphoma (JCOG0902A). Br J Haematol. 2014;166:739\u201348.","journal-title":"Br J Haematol"},{"key":"1534_CR10","doi-asserted-by":"publisher","first-page":"1258","DOI":"10.3324\/haematol.2017.164996","volume":"102","author":"S Fuji","year":"2017","unstructured":"Fuji S, Yamaguchi T, Inoue Y, Utsunomiya A, Moriuchi Y, Uchimaru K, et al. Development of a modified prognostic index for patients with aggressive adult T-cell leukemia-lymphoma aged 70 years or younger: possible risk-adapted management strategies including allogeneic transplantation. Haematologica. 2017;102:1258\u201365.","journal-title":"Haematologica"},{"key":"1534_CR11","doi-asserted-by":"publisher","DOI":"10.1038\/s41408-025-01367-w","volume":"15","author":"K Jimbo","year":"2025","unstructured":"Jimbo K, Ito A, Ichimura H, Kuroda J, Andoh S, Sato A, et al. Prognostic impact of organ involvement in aggressive adult T-cell leukemia\/lymphoma: definition of risk organ and proposal of a prognostic index. Blood Cancer J. 2025;15:166.","journal-title":"Blood Cancer J"},{"key":"1534_CR12","doi-asserted-by":"publisher","first-page":"3760","DOI":"10.1182\/bloodadvances.2024013089","volume":"8","author":"K Jimbo","year":"2024","unstructured":"Jimbo K, Kawamata T, Inamoto Y, Ito A, Yokoyama K, Sato A, et al. Flow cytometric profiles with CD7 and CADM1 in CD4+ T cells are promising indicators for prognosis of aggressive ATL. Blood Adv. 2024;8:3760\u201370.","journal-title":"Blood Adv"},{"key":"1534_CR13","doi-asserted-by":"publisher","first-page":"5133","DOI":"10.1182\/bloodadvances.2020003053","volume":"4","author":"K Yonekura","year":"2020","unstructured":"Yonekura K, Kusumoto S, Choi I, Nakano N, Ito A, Suehiro Y, et al. Mogamulizumab for adult T-cell leukemia-lymphoma: a multicenter prospective observational study. Blood Adv. 2020;4:5133\u201345.","journal-title":"Blood Adv"},{"key":"1534_CR14","doi-asserted-by":"publisher","first-page":"E517","DOI":"10.1016\/S1470-2045(14)70202-5","volume":"15","author":"K Ishitsuka","year":"2014","unstructured":"Ishitsuka K, Tamura K. Human T-cell leukaemia virus type I and adult T-cell leukaemia-lymphoma. Lancet Oncol. 2014;15:E517\u2013E526.","journal-title":"Lancet Oncol"},{"key":"1534_CR15","first-page":"1860","volume":"31","author":"PP Carbone","year":"1971","unstructured":"Carbone PP, Kaplan HS, Musshoff K, Smithers DW, Tubiana M. Report of the committee on Hodgkin\u2019s disease staging classification. Cancer Res. 1971;31:1860\u20131.","journal-title":"Cancer Res"},{"key":"1534_CR16","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1200\/JCO.2008.18.2428","volume":"27","author":"K Tsukasaki","year":"2009","unstructured":"Tsukasaki K, Hermine O, Bazarbachi A, Ratner L, Ramos JC, Harrington W, et al. Definition, prognostic factors, treatment, and response criteria of adult T-cell leukemia-lymphoma: a proposal from an international consensus meeting. J Clin Oncol. 2009;27:453\u20139.","journal-title":"J Clin Oncol"},{"key":"1534_CR17","doi-asserted-by":"publisher","first-page":"2851","DOI":"10.1158\/1078-0432.CCR-13-3169","volume":"20","author":"S Kobayashi","year":"2014","unstructured":"Kobayashi S, Nakano K, Watanabe E, Ishigaki T, Ohno N, Yuji K, et al. CADM1 expression and stepwise downregulation of CD7 are closely associated with clonal expansion of HTLV-I-infected cells in adult T-cell leukemia\/lymphoma. Clin Cancer Res. 2014;20:2851\u201361.","journal-title":"Clin Cancer Res"},{"key":"1534_CR18","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1111\/cas.12639","volume":"106","author":"S Kobayashi","year":"2015","unstructured":"Kobayashi S, Watanabe E, Ishigaki T, Ohno N, Yuji K, Nakano K, et al. Advanced human T-cell leukemia virus type 1 carriersand early-stage indolent adult T-cell leukemia-lymphoma are indistinguishable based on CADM1 positivity in flow cytometry. Cancer Sci. 2015;106:598\u2013603.","journal-title":"Cancer Sci"},{"key":"1534_CR19","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1038\/bmt.2012.244","volume":"48","author":"Y Kanda","year":"2013","unstructured":"Kanda Y. Investigation of the freely available easy-to-use software \u2018EZR\u2019 for medical statistics. Bone Marrow Transpl. 2013;48:452\u20138.","journal-title":"Bone Marrow Transpl"},{"key":"1534_CR20","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1111\/j.1365-2141.2006.06232.x","volume":"134","author":"M Siddiqui","year":"2006","unstructured":"Siddiqui M, Ristow K, Markovic SN, Witzig TE, Habermann TM, Colgan JP, et al. Absolute lymphocyte count predicts overall survival in follicular lymphomas. Br J Haematol. 2006;134:596\u2013601.","journal-title":"Br J Haematol"},{"key":"1534_CR21","doi-asserted-by":"publisher","first-page":"2227","DOI":"10.1038\/sj.leu.2404780","volume":"21","author":"DH Kim","year":"2007","unstructured":"Kim DH, Baek JH, Chae YS, Kim YK, Kim HJ, Park YH, et al. Absolute lymphocyte counts predicts response to chemotherapy and survival in diffuse large B-cell lymphoma. Leukemia. 2007;21:2227\u201330.","journal-title":"Leukemia"},{"key":"1534_CR22","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1002\/hon.2155","volume":"33","author":"YW Koh","year":"2015","unstructured":"Koh YW, Jung SJ, Yoon DH, Suh C, Cha HJ, Go H, et al. The absolute lymphocyte to monocyte ratio is associated with poor prognosis in classical Hodgkin lymphoma patients younger than 60 years of age. Hematol Oncol. 2015;33:133\u201340.","journal-title":"Hematol Oncol"},{"key":"1534_CR23","doi-asserted-by":"publisher","first-page":"1565","DOI":"10.1007\/s00277-020-04084-5","volume":"99","author":"M Watanabe","year":"2020","unstructured":"Watanabe M, Kanda J, Hishizawa M, Nishikori M, Kondo T, Yamashita K, et al. Lymphopenia at diagnosis predicts survival of patients with immunodeficiency-associated lymphoproliferative disorders. Ann Hematol. 2020;99:1565\u201373.","journal-title":"Ann Hematol"},{"key":"1534_CR24","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1111\/bjh.17895","volume":"196","author":"K Nosaka","year":"2022","unstructured":"Nosaka K, Kusumoto S, Nakano N, Choi I, Yoshimitsu M, Imaizumi Y, et al. Clinical significance of the immunoglobulin G heavy-chain repertoire in peripheral blood mononuclear cells of adult T-cell leukaemia-lymphoma patients receiving mogamulizumab. Br J Haematol. 2022;196:629\u201338.","journal-title":"Br J Haematol"},{"key":"1534_CR25","doi-asserted-by":"publisher","first-page":"1173","DOI":"10.3324\/haematol.2022.281435","volume":"108","author":"H Hiramatsu","year":"2023","unstructured":"Hiramatsu H, Nosaka K, Kusumoto S, Nakano N, Choi I, Yoshimitsu M, et al. Landscape of immunoglobulin heavy chain \u03b3 gene class switch recombination in patients with adult T-cell leukemia-lymphoma. Haematologica. 2023;108:1173\u20138.","journal-title":"Haematologica"},{"key":"1534_CR26","doi-asserted-by":"publisher","first-page":"17945","DOI":"10.1073\/pnas.1316796110","volume":"110","author":"D Sugiyama","year":"2013","unstructured":"Sugiyama D, Nishikawa H, Maeda Y, Nishioka M, Tanemura A, Katayama I, et al. Anti-CCR4 mAb selectively depletes effector-type FoxP3+CD4+ regulatory T cells, evoking antitumor immune responses in humans. Proc Natl Acad Sci USA. 2013;110:17945\u201350.","journal-title":"Proc Natl Acad Sci USA"},{"key":"1534_CR27","doi-asserted-by":"publisher","first-page":"2366","DOI":"10.1182\/blood-2015-07-567958","volume":"126","author":"EC Fink","year":"2015","unstructured":"Fink EC, Ebert BL. The novel mechanism of lenalidomide activity. Blood. 2015;126:2366\u20139.","journal-title":"Blood"}],"container-title":["Blood Cancer Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41408-026-01534-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41408-026-01534-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41408-026-01534-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T22:52:21Z","timestamp":1785883941000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41408-026-01534-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,1]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["1534"],"URL":"https:\/\/doi.org\/10.1038\/s41408-026-01534-7","relation":{},"ISSN":["2044-5385"],"issn-type":[{"value":"2044-5385","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,1]]},"assertion":[{"value":"8 February 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 April 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 May 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 June 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"KJ has received honoraria from Daiichi Sankyo, Kyowa Kirin, Minophagen, Meiji Seika Pharma, and Takeda Pharmaceutical. JM has received consulting fees from Janssen Pharmaceutical; honoraria from AbbVie GK, Chugai Pharmaceutical, Genmab, Kyowa Kirin, Minophagen, Ono Pharmaceutical, Takeda Pharmaceutical, AstraZeneca, Daiichi Sankyo, Janssen Pharmaceutical, Meiji Seika Pharma, Nippon Shinyaku, and Sanofi; and support for attending meetings and\/or travel from Takeda Pharmaceutical. KN has received research funding from Kyowa Kirin and Chugai Pharmaceutical; and honoraria from Meiji Seika Pharma, Chugai Pharmaceutical, Bristol Myers Squibb, Kyowa Kirin, AbbVie GK, Daiichi Sankyo, Eisai, Ohara, Janssen Pharmaceutical, and Minophagen.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"This study was conducted in accordance with all relevant institutional guidelines and regulations. All patients were enrolled after they had provided written informed consent in accordance with the Declaration of Helsinki. This study was approved by the Institutional Review Board of the National Cancer Center Research Institute (2024-358) and the Institute of Medical Science, The University of Tokyo (2024-74-1211).","order":2,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Ethics"}}],"article-number":"130"}}