Recent advances in the treatment of adult T‐cell leukemia‐lymphomas. Issue 4 (6th March 2015)

• Record Type: Journal Article
• Authors: Utsunomiya, Atae; Choi, Ilseung; Chihara, Dai; Seto, Masao
• Is Part Of: Cancer science. Volume 106:Issue 4(2015:Apr.)
• Page Start: 344
• Page End: 351
• Publication Date: 2015-03-06
• Subjects: Adult T‐cell leukemia‐lymphoma -- allogeneic hematopoietic stem cell transplantation -- antiviral therapy -- chemotherapy -- molecular targeted therapy; Cancer -- Periodicals; Neoplasms -- Periodicals; Research -- Periodicals; Electronic journals; 616.994005
• DOI: 10.1111/cas.12617
• Languages: English
• ISSNs: 1347-9032

Abstract

Abstract : Recent advances in treatment for adult T‐cell leukemia‐lymphoma (ATL) are reviewed herein. It is currently possible to select a therapeutic strategy for ATL and predict prognosis by classification of patients by clinical subtypes and clinicopathological factors. Although the overall survival (OS) of patients with ATL has increased marginally because of advances in chemotherapy, further prolongation of survival might be difficult with conventional chemotherapy alone. Promising results have been reported for antiviral therapy using zidovudine and interferon‐α, and, indeed, antiviral therapy is currently the standard treatment for patients with ATL in western countries. Remarkably, the 5‐year OS rates are 100% for both the smoldering‐type and chronic‐type ATL. Recently, treatments for ATL have included allogeneic hematopoietic stem cell transplantation and molecular targeted therapies. Furthermore, the anti‐CCR4 monoclonal antibody mogamulizumab has been shown to have marked cytotoxic effects on ATL cells, especially in the leukemic type of ATL. In the lymphoma type of ATL, the response rate may be improved by combining mogamulizumab with chemotherapy. It should be recognized that prevention of infection from carriers of human T‐cell leukemia virus type‐I and transfer of the virus from mother to infant are crucial issues for the eradication of ATL. Abstract : The prognosis of ATL is very poor by conventional chemotherapies. On the other hands, antiviral therapy of zidovudine and interferon‐α is currently the gold standard for patients with leukemic type ATL in Western countries although it is not confirmed yet in Japan. By various attempts including allogeneic hematopoietic stem cell transplantation and molecular target therapies, around one‐third of aggressive type ATL cases can be now cured.