Human T-cell leukaemia virus type I and adult T-cell leukaemia-lymphoma

Lancet Oncol. 2014 Oct;15(11):e517-26. doi: 10.1016/S1470-2045(14)70202-5.

Abstract

Adult T-cell leukaemia-lymphoma (ATL) is a malignancy of peripheral T lymphocytes caused by human T-lymphotropic virus type I (HTLV-1), and its prognosis is poor. There are an estimated 5 million to 20 million HTLV-1 infected individuals worldwide; their lifetime risk of developing ATL is 3-5%, and high HTLV-1 proviral loads have been shown to be an independent risk factor. Recent advances in the treatment of ATL are the introduction of treatment targeted against CC chemokine receptor 4 (CCR4), which is abundantly expressed on most ATL cells, and allogeneic haemopoietic stem-cell transplantation for aggressive ATL. Promising outcomes are also reported with early intervention for indolent ATL with interferon α and zidovudine. Clinical trials should incorporate a validated prognostic index to assess the results, because of the difficulties associated with undertaking large-scale trials and significant diversity of clinical features with ATL, even in the same clinical subtypes (acute, lymphoma, chronic, and smoldering).

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Combined Modality Therapy
  • Female
  • HTLV-I Infections / complications*
  • HTLV-I Infections / diagnosis
  • HTLV-I Infections / transmission
  • Hematopoietic Stem Cell Transplantation / methods
  • Human T-lymphotropic virus 1 / isolation & purification*
  • Humans
  • Interferon-alpha / therapeutic use
  • Leukemia-Lymphoma, Adult T-Cell / etiology*
  • Leukemia-Lymphoma, Adult T-Cell / mortality
  • Leukemia-Lymphoma, Adult T-Cell / therapy*
  • Male
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Prognosis
  • Risk Assessment
  • Survival Analysis
  • Treatment Outcome

Substances

  • Interferon-alpha