{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T09:12:39Z","timestamp":1766049159013,"version":"3.40.5"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,5,16]],"date-time":"2019-05-16T00:00:00Z","timestamp":1557964800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">JCOG<\/jats:styled-content>9801, a randomized phase <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content> trial, reported that vincristine, cyclophosphamide, doxorubicin and prednisone (<jats:styled-content style=\"fixed-case\">VCAP<\/jats:styled-content>); doxorubicin, ranimustine and prednisone (<jats:styled-content style=\"fixed-case\">AMP<\/jats:styled-content>); and vindesine, etoposide, carboplatin and prednisone (<jats:styled-content style=\"fixed-case\">VECP<\/jats:styled-content>) (<jats:styled-content style=\"fixed-case\">VCAP<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">AMP<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">VECP<\/jats:styled-content>;<jats:styled-content style=\"fixed-case\"> mLSG<\/jats:styled-content>15) showed superior clinical outcomes when compared to cyclophosphamide, doxorubicin, vincristine and prednisone every 2\u00a0weeks (<jats:styled-content style=\"fixed-case\">CHOP<\/jats:styled-content>\u201014; <jats:styled-content style=\"fixed-case\">mLSG<\/jats:styled-content>19) in patients with untreated aggressive adult T\u2010cell leukaemia\u2010lymphoma (<jats:styled-content style=\"fixed-case\">ATL<\/jats:styled-content>). To identify patients who require <jats:styled-content style=\"fixed-case\">VCAP<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">AMP<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">VECP<\/jats:styled-content>, we conducted a supplementary analysis of <jats:styled-content style=\"fixed-case\">JCOG<\/jats:styled-content>9801. Overall, 105 patients were included and categorized into low\u2010 (<jats:italic>n<\/jats:italic>\u00a0=\u00a044), intermediate\u2010 (<jats:italic>n<\/jats:italic>\u00a0=\u00a054) and high\u2010risk (<jats:italic>n<\/jats:italic>\u00a0=\u00a07) groups according to the age\u2010adjusted <jats:styled-content style=\"fixed-case\">ATL<\/jats:styled-content> prognostic index (<jats:styled-content style=\"fixed-case\">ATL<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">PI<\/jats:styled-content>). We excluded the high\u2010risk group due to small numbers of patients. <jats:styled-content style=\"fixed-case\">VCAP<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">AMP<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">VECP<\/jats:styled-content> did not show any superior trend for overall survival (<jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content>) in the low\u2010risk group (hazard ratio: 1\u00b704; 95% confidence interval: 0\u00b754\u20132\u00b704). Better <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content> was observed in the intermediate\u2010risk group treated with <jats:styled-content style=\"fixed-case\">VCAP<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">AMP<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">VECP<\/jats:styled-content> (hazard ratio: 0\u00b765; 95% confidence interval: 0\u00b736\u20131\u00b719). In the intermediate\u2010risk group, the <jats:styled-content style=\"fixed-case\">VCAP<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">AMP<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">VECP<\/jats:styled-content> arm showed higher complete response rates than the <jats:styled-content style=\"fixed-case\">CHOP<\/jats:styled-content>\u201014 arm (44\u00b70% vs. 13\u00b78%). The <jats:styled-content style=\"fixed-case\">VCAP<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">AMP<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">VECP<\/jats:styled-content> arm in both risk groups exhibited grade 4 thrombocytopenia, while grade 4 neutropenia was only observed in the intermediate\u2010risk group. <jats:styled-content style=\"fixed-case\">VCAP<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">AMP<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">VECP<\/jats:styled-content> remains suitable for the intermediate\u2010risk group, whereas its benefits appear modest in the low\u2010risk group.<\/jats:p>","DOI":"10.1111\/bjh.15950","type":"journal-article","created":{"date-parts":[[2019,5,17]],"date-time":"2019-05-17T04:37:59Z","timestamp":1558067879000},"page":"440-447","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Possibility of a risk\u2010adapted treatment strategy for untreated aggressive adult T\u2010cell leukaemia\u2010lymphoma (<scp>ATL<\/scp>) based on the <scp>ATL<\/scp> prognostic index: a supplementary analysis of the <scp>JCOG<\/scp>9801"],"prefix":"10.1111","volume":"186","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8125-4528","authenticated-orcid":false,"given":"Kosuke","family":"Toyoda","sequence":"first","affiliation":[{"name":"Department of Hematology, Rheumatology and Infectious Diseases Faculty of Life Sciences Kumamoto University of Medicine Kumamoto 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