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Open Access 10-01-2025 | Lymphoma | Research

Prognosis of aggressive adult T-cell leukemia/lymphoma with central nervous system infiltration and utility of CD7 versus CADM1 flowcytometric plots of cerebrospinal fluid

Authors: Koji Jimbo, Tomohiro Ishigaki, Masataka Sakashita, Shohei Andoh, Hirona Ichimura, Ayumu Ito, Kazuaki Yokoyama, Aki Sato, Takahiro Fukuda, Kaoru Uchimaru, Yasuhito Nannya

Published in: Annals of Hematology

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Abstract

The prognosis of adult T-cell leukemia/lymphoma (ATL) with primary central nervous system (CNS) involvement has been unclear since the advent of new therapies. Recently, we have shown that flow cytometric CD7/CADM1 analysis of CD4 + cells (HAS-Flow) is useful to detect ATL cells that are not morphologically diagnosed as ATL cells. We investigated the role of CNS involvement in ATL using cytology and HAS-Flow by analyzing cerebrospinal fluid (CSF) from 73 aggressive ATL cases. Based on the findings in CSF, the study subjects were classified into CNS + (cytologically malignant, n = 18), CNS- (cytologically non-malignant and ATL cell population negative in HAS-Flow, n = 44), and CNS-Micro (cytologically non-malignant and ATL cell population positive in HAS-Flow, n = 11) groups. As expected, the CNS + group had a shorter overall survival than the CNS- groups (P < 0.001). However, the CNS-Micro group showed no adverse impact on overall survival compared to the CNS- group (P = 0.506), even without additional CNS-targeted treatments. HAS-Flow also demonstrated clinical utility in the diagnosis of CSF lesions in ATL patients with cerebral white matter lesions and in the detection of ATL cells on post-treatment CSF examination in patients with CNS involvement. Our study demonstrates that ATL with CNS involvement have a poor prognosis and that CSF HAS-Flow is useful to assist in the diagnosis of suspected CNS involvement and to detect ATL cells with high sensitivity after treatment.
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Literature
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Metadata
Title
Prognosis of aggressive adult T-cell leukemia/lymphoma with central nervous system infiltration and utility of CD7 versus CADM1 flowcytometric plots of cerebrospinal fluid
Authors
Koji Jimbo
Tomohiro Ishigaki
Masataka Sakashita
Shohei Andoh
Hirona Ichimura
Ayumu Ito
Kazuaki Yokoyama
Aki Sato
Takahiro Fukuda
Kaoru Uchimaru
Yasuhito Nannya
Publication date
10-01-2025
Publisher
Springer Berlin Heidelberg
Keywords
Lymphoma
Leukemia
Published in
Annals of Hematology
Print ISSN: 0939-5555
Electronic ISSN: 1432-0584
DOI
https://doi.org/10.1007/s00277-025-06186-4

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