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Therapeutic approaches for HTLV-1-associated adult T-cell leukemia/lymphoma: a comprehensive review

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Abstract

Adult T-cell leukemia/lymphoma (ATLL), an infrequent malignancy resultant from human T-cell lymphotropic virus type I (HTLV-1), exhibits a spectrum of phenotypes, encompassing acute, smoldering, lymphomatous, and chronic variants, each bearing distinct clinical presentations. The preponderant acute manifestation is characterized by hypercalcemia, systemic manifestations, organomegaly, and dermatological eruptions. Conversely, the chronic phenotype is typified by lymphocytosis and/or cutaneous eruptions, while smoldering ATLL assumes an asymptomatic course. Immunocompromise afflicts ATLL patients, heightening their vulnerability to opportunistic infections that frequently intricately intertwine with disease progression. Therefore, an early diagnosis is crucial to manage the disease appropriately. While conventional chemotherapeutic regimens have shown limited success, especially in acute and lymphoma types, recent studies suggest that allogeneic stem cell transplantation might enhance treatment results because it has shown promising outcomes in some patients. Novel therapeutics, such as interferon and monoclonal antibodies, have also shown promise, but more research is needed to confirm their efficacy. Moreover, the identification of biomarkers for ATLL and genetic changes in HTLV-1 infected cells has led to the development of targeted therapies that have shown remarkable success in clinical trials. These targeted therapies have the potential to offer a more personalized approach to the treatment of ATLL. The aim of our review is to elaborate on conventional and novel therapies and the efficiency of mentioned treatments.

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Authors and Affiliations

  1. Department of Virology, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran

    Arash Letafati & Mehdi Norouzi

  2. Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran

    Arash Letafati, Roben Soheili, Mehdi Norouzi & Sayed-Hamidreza Mozhgani

  3. Advanced Science Faculty, Tehran Medical Branch, Islamic Azad University, Tehran, Iran

    Parastoo Soleimani

  4. Department of Microbiology and Virology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran

    Sayed-Hamidreza Mozhgani

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Letafati, A., Soheili, R., Norouzi, M. et al. Therapeutic approaches for HTLV-1-associated adult T-cell leukemia/lymphoma: a comprehensive review. Med Oncol 40, 295 (2023). https://doi.org/10.1007/s12032-023-02166-8

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