Definition, prognostic factors, treatment, and response criteria of adult T-cell leukemia-lymphoma: A proposal from an international consensus meeting

Kunihiro Tsukasaki, Olivier Hermine, Ali Bazarbachi, Lee Ratner, Juan Carlos Ramos, William Harrington, Deirdre O'Mahony, John E. Janik, Achiléa L. Bittencourt, Graham P. Taylor, Kazunari Yamaguchi, Atae Utsunomiya, Kensei Tobinai, Toshiki Watanabe

Research output: Contribution to journalArticle

320 Citations (Scopus)

Abstract

Adult T-cell leukemia-lymphoma (ATL) is a distinct peripheral T-lymphocytic malignancy associated with a retrovirus designated human T-cell lymphotropic virus type I (HTLV-1). The diversity in clinical features and prognosis of patients with this disease has led to its subclassification into the following four categories: acute, lymphoma, chronic, and smoldering types. The chronic and smoldering subtypes are considered indolent and are usually managed with watchful waiting until disease progression, analogous to the management of some patients with chronic lymphoid leukemia (CLL) or other indolent histology lymphomas. Patients with aggressive ATL generally have a poor prognosis because of multidrug resistance of malignant cells, a large tumor burden with multiorgan failure, hypercalcemia, and/or frequent infectious complications as a result of a profound T-cell immunodeficiency. Under the sponsorship of the 13th International Conference on Human Retrovirology: HTLV, a group of ATL researchers joined to form a consensus statement based on established data to define prognostic factors, clinical subclassifications, and treatment strategies. A set of response criteria specific for ATL reflecting a combination of those for lymphoma and CLL was proposed. Clinical subclassification is useful but is limited because of the diverse prognosis among each subtype. Molecular abnormalities within the host genome, such as tumor suppressor genes, may account for these diversities. A treatment strategy based on the clinical subclassification and prognostic factors is suggested, including watchful waiting approach, chemotherapy, antiviral therapy, allogeneic hematopoietic stem-cell transplantation (alloHSCT), and targeted therapies.

Original languageEnglish
Pages (from-to)453-459
Number of pages7
JournalJournal of Clinical Oncology
Volume27
Issue number3
DOIs
StatePublished - Jan 20 2009
Externally publishedYes

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Adult T Cell Leukemia Lymphoma
Watchful Waiting
Lymphoid Leukemia
Lymphoma
T-Lymphocytes
Therapeutics
Human T-lymphotropic virus 1
Hematopoietic Stem Cell Transplantation
Hypercalcemia
Multiple Drug Resistance
Retroviridae
Tumor Burden
Tumor Suppressor Genes
Antiviral Agents
Disease Progression
Histology
Research Personnel
Genome
Viruses
Drug Therapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Definition, prognostic factors, treatment, and response criteria of adult T-cell leukemia-lymphoma : A proposal from an international consensus meeting. / Tsukasaki, Kunihiro; Hermine, Olivier; Bazarbachi, Ali; Ratner, Lee; Carlos Ramos, Juan; Harrington, William; O'Mahony, Deirdre; Janik, John E.; Bittencourt, Achiléa L.; Taylor, Graham P.; Yamaguchi, Kazunari; Utsunomiya, Atae; Tobinai, Kensei; Watanabe, Toshiki.

In: Journal of Clinical Oncology, Vol. 27, No. 3, 20.01.2009, p. 453-459.

Research output: Contribution to journalArticle

Tsukasaki, K, Hermine, O, Bazarbachi, A, Ratner, L, Carlos Ramos, J, Harrington, W, O'Mahony, D, Janik, JE, Bittencourt, AL, Taylor, GP, Yamaguchi, K, Utsunomiya, A, Tobinai, K & Watanabe, T 2009, 'Definition, prognostic factors, treatment, and response criteria of adult T-cell leukemia-lymphoma: A proposal from an international consensus meeting', Journal of Clinical Oncology, vol. 27, no. 3, pp. 453-459. https://doi.org/10.1200/JCO.2008.18.2428
Tsukasaki, Kunihiro ; Hermine, Olivier ; Bazarbachi, Ali ; Ratner, Lee ; Carlos Ramos, Juan ; Harrington, William ; O'Mahony, Deirdre ; Janik, John E. ; Bittencourt, Achiléa L. ; Taylor, Graham P. ; Yamaguchi, Kazunari ; Utsunomiya, Atae ; Tobinai, Kensei ; Watanabe, Toshiki. / Definition, prognostic factors, treatment, and response criteria of adult T-cell leukemia-lymphoma : A proposal from an international consensus meeting. In: Journal of Clinical Oncology. 2009 ; Vol. 27, No. 3. pp. 453-459.
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