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Adult T-Cell Leukemia: a Comprehensive Overview on Current and Promising Treatment Modalities

  • Lymphomas (T Hilal, Section Editor)
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Abstract

Purpose of the Review

Adult T-cell leukemia (ATL) is an aggressive chemo-resistant malignancy secondary to HTLV-1 retrovirus. Prognosis of ATL remains dismal. Herein, we emphasized on the current ATL treatment modalities and their drawbacks, and opened up on promising targeted therapies with special focus on the HTLV-1 regulatory proteins Tax and HBZ.

Recent Findings

Indolent ATL and a fraction of acute ATL exhibit long-term survival following antiviral treatment with zidovudine and interferon-alpha. Monoclonal antibodies such as mogamulizumab improved response rates, but with little effect on survival. Allogeneic hematopoietic cell transplantation results in long-term survival in one third of transplanted patients, alas only few patients are transplanted. Salvage therapy with lenalidomide in relapsed/refractory patients leads to prolonged survival in some of them.

Summary

ATL remains an unmet medical need. Targeted therapies focusing on the HTLV-1 viral replication and/or viral regulatory proteins, as well as on the host antiviral immunity, represent a promising approach for the treatment of ATL.

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Authors and Affiliations

  1. Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon

    Rita Hleihel, Abdou Akkouche, Hala Skayneh & Ali Bazarbachi

  2. Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon

    Rita Hleihel, Abdou Akkouche, Hala Skayneh & Ali Bazarbachi

  3. Institut Imagine—INSERM U1163, Necker Hospital, University of Paris, 75015, Paris, France

    Olivier Hermine

  4. Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon

    Hiba El Hajj

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Hleihel, R., Akkouche, A., Skayneh, H. et al. Adult T-Cell Leukemia: a Comprehensive Overview on Current and Promising Treatment Modalities. Curr Oncol Rep 23, 141 (2021). https://doi.org/10.1007/s11912-021-01138-3

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