Prognostic significance of Tryptophan catabolism in adult t-cell leukemia/lymphoma

Ayako Masaki, Takashi Ishida, Yasuhiro Maeda, Susumu Suzuki, Asahi Ito, Hisashi Takino, Hiroka Ogura, Haruhito Totani, Takashi Yoshida, Shiori Kinoshita, Tomoko Narita, Masaki Ri, Shigeru Kusumoto, Atsushi Inagaki, Hirokazu Komatsu, Akio Niimi, Ryuzo Ueda, Atae Utsunomiya, Hiroshi Inagaki, Shinsuke Iida

Research output: Contribution to journalArticlepeer-review

34 Citations (Scopus)


Purpose: Indoleamine 2,3-dioxygenase 1 (IDO1: IDO), an enzyme catabolizing tryptophan (Trp) into the kynurenine (Kyn) pathway, is increasingly being recognized as an important microenvironmental factor suppressing antitumor immune responses. The purpose of the present study was to determine the prognostic significance of Trp catabolism in adult T-cell leukemia/lymphoma (ATL). Experimental Design: We quantified serum Trp and Kyn in 96 ATL patients, 38 human T-cell lymphotropic virus type-1 asymptomatic carriers (HTLV-1 ACs), and 40 healthy adult volunteer controls. The relationships between various clinical parameters including overall survival were analyzed. IDO expression was evaluated in the affected lymph nodes of ATL patients. Results: Serum Kyn concentrations and Kyn/Trp ratios were significantly higher in HTLV-1 ACs than healthy controls. Both increased significantly with progression from HTLV-1 AC to ATL. However, there were no significant differences in the serum Trp concentrations between ATL patients, HTLV-1 ACs, and controls. IDO was possibly produced by ATL and/or cells of the microenvironment. Multivariate analyses demonstrated that a high serum Kyn/Trp ratio and high Kyn level, but not a high Trp level, were significantly independent detrimental prognostic factors in ATL, as well as in that subset of patients with aggressive variant ATL. Conclusions: Quantification of serum Kyn and Trp is useful for predicting prognosis of an individual ATL patient. Furthermore, ATL, especially in patients with a high serum Kyn/ Trp ratio, is an appropriate disease for testing novel cancer immunotherapies targeting IDO.

Original languageEnglish
Pages (from-to)2830-2839
Number of pages10
JournalClinical Cancer Research
Issue number12
Publication statusPublished - 15-06-2015
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research


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