Adult T-cell leukemia-lymphoma: Current treatment strategies and novel immunological approaches

Ryuji Tanosaki, Kensei Tobinai

Research output: Contribution to journalReview article

16 Citations (Scopus)

Abstract

Adult T-cell leukemia-lymphoma (ATL) is a peripheral T-cell malignancy, closely associated with human T-cell lymphotropic virus type I infection. Clinically, ATL is classified into four subtypes: acute, lymphoma, chronic and smoldering type. Although the prognosis of chronic and smoldering-type ATL is relatively good, that of patients with acute- or lymphoma-type ATL still remains extremely poor. Zidovudine/IFN-α therapy seems to be promising, although its efficacy has not yet been confirmed in well-designed prospective studies. High-dose chemotherapy with the support of autologous transplantation does not improve outcome. Allogeneic stem cell transplantation is promising and approximately 40% of aggressive ATL patients are expected to survive long-term, although transplantation-related mortality is as high as 40-50%. Stem cell transplantation using reduced-intensity conditioning is also effective and safer, with graft-versus-ATL and graft-versus-human T-cell lymphotropic virus type I effects observed after transplantation. Novel approaches including new agents such as purine nucleoside phosphorylase inhibitors and histone deacetylase inhibitors, or targeted immunotherapy using antichemokine receptor-4 antibody or dendritic cell/peptide vaccine are also warranted.

Original languageEnglish
Pages (from-to)743-753
Number of pages11
JournalExpert Review of Hematology
Volume3
Issue number6
DOIs
Publication statusPublished - 2010 Dec 1
Externally publishedYes

Keywords

  • IFN-α
  • adult T-cell leukemia-lymphoma
  • graft-versus-ATL effects
  • graft-versus-HTLV-1 effects
  • hematopoietic stem cell transplantation
  • human T-cell lymphotropic virus type I
  • reduced-intensity stem cell transplantation
  • treatment
  • zidovudine

ASJC Scopus subject areas

  • Hematology

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