Authors
Shigeo Fuji, Masahito Tokunaga, Lucy Cook, Atae Utsunomiya, Junya Makiyama, Youko Suehiro, Ki-Ryang Koh, Makoto Nakashima, Yoshihisa Yamano, Kaoru Uchimaru
Published in
EJHaem. Volume 7. Issue 4. Pages e70345. Epub Jul 03, 2026.
Abstract
Adult T-cell leukemia/lymphoma (ATL) exhibits marked clinical heterogeneity; however, current classification primarily rely on morphology and laboratory findings and require further advancement. This study aimed to evaluate the roles of human T-lymphotropic virus type 1 (HTLV-1)-infected cell (CD4-positive T cell) analysis system using flow cytometry (HAS-Flow) and absolute CD4 count in prognostic assessment of nonaggressive ATL.
We retrospectively analyzed 227 individuals with HTLV-1 infection in Japan (derivation cohort) and 81 in the United Kingdom (validation cohort). HAS-Flow categorized patients into G1-G4 groups according to the proportion of cell adhesion molecule 1 (CADM1)+/CD7- cells. Clinical outcomes were compared by HAS-Flow and absolute CD4 count (cutoff: 1500 cells/µL) using Kaplan-Meier and Cox analyses.
In the derivation cohort, 4-year progression-free survival (PFS) rates were 100% for G1-G2, 94.2% for G3, and 55.7% for G4 (p < 0.01). Absolute CD4 counts >1500 cells/µL identified patients with significantly shorter PFS and overall survival. G4 patients showed poor prognosis irrespective of CD4 counts. The UK validation cohort reproduced the prognostic CD4 counts >1500 cells/µL.
HAS-Flow and absolute CD4 count provide additive prognostic information beyond the Shimoyama classification.
The authors have confirmed clinical trial registration is not needed for this submission.
PMID:
42405269
Bibliographic data and abstract were imported from PubMed on 06 Jul 2026.
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