{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T22:18:05Z","timestamp":1775081885720,"version":"3.50.1"},"reference-count":34,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,6,16]],"date-time":"2018-06-16T00:00:00Z","timestamp":1529107200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["17K09934"],"award-info":[{"award-number":["17K09934"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Science"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:p>Aggressive adult T\u2010cell leukemia\/lymphoma (ATL) has an extremely poor prognosis and is hyperendemic in Okinawa, Japan. This study evaluated two prognostic indices (PIs) for aggressive ATL, the ATL\u2010PI and Japan Clinical Oncology Group (JCOG)\u2010PI, in a cohort from Okinawa. The PIs were originally developed using two different Japanese cohorts that included few patients from Okinawa. The endpoint was overall survival (OS). Multivariable Cox regression analyses in the cohort of 433 patients revealed that all seven factors for calculating each PI were statistically significant prognostic predictors. Three\u2010year OS rates for ATL\u2010PI were 35.9% (low\u2010risk, n\u00a0=\u00a066), 10.4% (intermediate\u2010risk, n\u00a0=\u00a0256), and 1.6% (high\u2010risk, n\u00a0=\u00a0111), and those for JCOG\u2010PI were 22.4% (moderate\u2010risk, n\u00a0=\u00a0176) and 5.3% (high\u2010risk, n\u00a0=\u00a0257). The JCOG\u2010PI moderate\u2010risk group included both the ATL\u2010PI low\u2010 and intermediate\u2010risk groups. ATL\u2010PI more clearly identified the low\u2010risk patient subgroup than JCOG\u2010PI. To evaluate the external validity of the two PIs, we also assessed prognostic discriminability among 159 patients who loosely met the eligibility criteria of a previous clinical trial. Three\u2010year OS rates for ATL\u2010PI were 34.5% (low\u2010risk, n\u00a0=\u00a042), 9.2% (intermediate\u2010risk, n\u00a0=\u00a0109), and 12.5% (high\u2010risk, n\u00a0=\u00a08). Those for JCOG\u2010PI were 22.4% (moderate\u2010risk, n\u00a0=\u00a095) and 7.6% (high\u2010risk, n\u00a0=\u00a064). The low\u2010risk ATL\u2010PI group had a better prognosis than the JCOG\u2010PI moderate\u2010risk group, suggesting that ATL\u2010PI would be more useful than JCOG\u2010PI for establishing and examining novel treatment strategies for ATL patients with a better prognosis. In addition, strongyloidiasis, previously suggested to be associated with ATL\u2010related deaths in Okinawa, was not a prognostic factor in this study.<\/jats:p>","DOI":"10.1111\/cas.13641","type":"journal-article","created":{"date-parts":[[2018,5,17]],"date-time":"2018-05-17T21:31:40Z","timestamp":1526592700000},"page":"2286-2293","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Evaluation of two prognostic indices for adult T\u2010cell leukemia\/lymphoma in the subtropical endemic area, Okinawa, Japan"],"prefix":"10.1111","volume":"109","author":[{"given":"Keita","family":"Tamaki","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology Second Department of Internal Medicine Graduate School of Medicine University of the Ryukyus Nishihara 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