Anemia in Acute ATLL Patients

We analyzed patients with acute or lymphoma-type ATLL who were diagnosed at our hospital between 2014 and 2020 and underwent initial treatment with a CHOP (doxorubicin, cyclophosphamide, vincristine, prednisone)-based chemotherapy regimen. Patients who received mogamulizumab in combination with CHOP therapy were also included in this analysis. Patients with any of the following histories were excluded: 1) receiving any anti-cancer drugs, immunosuppressants, or radiation therapy within the last five years; and 2) having any serious infectious diseases within the past 12 months. We also excluded patients with iron or vitamin deficiencies at the time of initial diagnosis. To minimize the effect of anticancer drugs on hematopoiesis and RBC morphology, peripheral blood smears and laboratory data were collected within two weeks of treatment intervention. Based on past clinical observations, these two weeks was the time when the actual major changes in RBC morphology have been observed. Blood smears were collected exclusively from the patients with acute-type ATLL who were available for the appraisable peripheral blood smears and were evaluated by a physician and authorized laboratory technologists. Data on the peripheral blood cell count, mean corpuscular volume (MCV), red cell distribution width (RDW), hemoglobin (Hb), lactate dehydrogenase (LDH), and soluble interleukin-2 receptor (sIL-2R) were collected, and the trends of these data over time were examined. To examine the factors influencing the progression of anemia, the association between the degree of progression of anemia and LDH, sIL2R, and RDW was statistically analyzed. Statistical analyses were conducted using the Shapiro test and cor test functions of R version 4.2.0.