Jingjian Wang

Background: Adult T-cell leukemia/lymphoma (ATL) is a rare and aggressive type of peripheral T-cell malignancy caused by the human T-lymphotropic virus type 1 (HTLV-1). Approximately 5 to 10 million people are infected with HTLV-1 worldwide, with high prevalence in Japan. This observational study analyzed patient characteristics, treatment patterns, healthcare resource utilization (HRU), and costs of ATL in Japan. Methods: A retrospective analysis of ATL patients from the Medical Data Vision database, Sept. 1, 2012–Aug. 31, 2022, was conducted. Results: Among 1572 ATL patients, 384 received systemic therapy. The mean age at diagnosis was 66.4 years, with 63.7% being ≥65 years; 55.2% patients were females. Excluding cancer, 61% of patients had a Charlson Comorbidity Index score of 0. The most frequently observed comorbidities were congestive heart failure (15.8%), diabetes (14.8%), and peptic ulcer disease (14.6%). Among the treated patients, 37.5% received 1 line of therapy, 26% received 2 lines of therapy, and 36.5% received ≥3 lines. Mogamulizumab was most frequently utilized (60.4%), as monotherapy or in combination regimens. The most common combination regimen in all lines of therapy were cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), utilized in 46.6% of patients. Additionally, use of combinations such as VCAP-AMP-VECP, which include vincristine, cyclophosphamide, doxorubicin, and prednisone; adriamycin, manimustine, and prednisone; and vindesine, etoposide, carboplatin, and prednisone, was observed in 33.3% of patients. Initial treatment was discontinued in 74.7% patients; only 3.4% received stem cell transplants. Most (96%) patients were hospitalized, 29.7% had emergency room visits, and 79.4% averaged 1.8 outpatient visits monthly. The mean all-cause healthcare cost per patient per month was $29 538 (¥4 647 300), mainly due to outpatient visits and hospitalizations. Conclusion: Although real-world studies based on MDV database have certain limitations, the findings of this study provide deeper understanding of the real-world patient characteristics, treatment patterns, HRU, and costs of ATL patients in Japan. The results indicate that patients often encounter high treatment costs and frequent hospitalizations, demonstrating the necessity for advanced regimens and highlighting the unmet need for more effective therapies in ATL patients that may reduce HRU and economic burden in this patient population.

Background: Peripheral T-cell lymphomas (PTCLs) are a rare and heterogeneous group of non-Hodgkin lymphomas associated with aggressive clinical course and suboptimal outcomes. PTCL accounts for a higher proportion of non-Hodgkin lymphoma cases in Japan compared with Western countries; however, real-world evidence on treatment patterns, healthcare resource utilization (HRU), and costs in Japan is limited. Objectives: To describe real-world patient characteristics, treatment patterns, HRU, and costs among patients with PTCL in Japan. Methods: This retrospective observational study used administrative claims data from the Medical Data Vision database in Japan. Adult patients diagnosed with PTCL between September 2012 and August 2022 were identified. Patients were categorized as receiving nonsystemic therapy or systemic therapy and stratified by lines of therapy. Patient demographics, comorbidities, treatment regimens, time on treatment, HRU, and healthcare costs, measured per patient per month, were analyzed descriptively. Results: Among 910 patients identified, 71.3% received systemic treatment and 28.7% received nonsystemic therapy, most receiving corticosteroids only. Mean age at diagnosis was 69.8 years; 70% of patients were at least 65 years old. Key comorbidities included peptic ulcer disease, congestive heart failure, and diabetes. PTCL–not otherwise specified and angioimmunoblastic T-cell lymphoma accounted for over 75% of subtypes. First-line therapy was mainly cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or CHOP-like regimens; later lines were more heterogeneous and of shorter duration. Mogamulizumab and brentuximab vedotin were used in 4.16% and 10.48% of patients, respectively. Stem cell transplantation was infrequent (6.3%). Median per patient per month PTCL-related total healthcare cost was $9712; median drug ($7056.9) and hospitalization costs ($5177.7) were the main contributors. Discussion: These findings demonstrate substantial clinical and economic burden among PTCL patients in Japan. Treatment heterogeneity and short duration in later lines of therapy highlight ongoing therapeutic challenges. Conclusions: High economic burden of PTCL treatment underscores the need for more effective, tolerable, and less costly therapeutic strategies for treating PTCL patients in Japan.