Revised Adult T-Cell Leukemia-Lymphoma International Consensus Meeting Report Academic Article Article uri icon

Overview

MeSH Major

  • Cord Blood Stem Cell Transplantation
  • Hematologic Neoplasms
  • Melphalan
  • Myeloablative Agonists
  • Radiation Dosage
  • Transplantation Conditioning
  • Vidarabine
  • Whole-Body Irradiation

abstract

  • PURPOSE: Adult T-cell leukemia-lymphoma (ATL) is a distinct mature T-cell malignancy caused by chronic infection with human T-lymphotropic virus type 1 with diverse clinical features and prognosis. ATL remains a challenging disease as a result of its diverse clinical features, multidrug resistance of malignant cells, frequent large tumor burden, hypercalcemia, and/or frequent opportunistic infection. In 2009, we published a consensus report to define prognostic factors, clinical subclassifications, treatment strategies, and response criteria. The 2009 consensus report has become the standard reference for clinical trials in ATL and a guide for clinical management. Since the last consensus there has been progress in the understanding of the molecular pathophysiology of ATL and risk-adapted treatment approaches. METHODS: Reflecting these advances, ATL researchers and clinicians joined together at the 18th International Conference on Human Retrovirology-Human T-Lymphotropic Virus and Related Retroviruses-in Tokyo, Japan, March, 2017, to review evidence for current clinical practice and to update the consensus with a new focus on the subtype classification of cutaneous ATL, CNS lesions in aggressive ATL, management of elderly or transplantation-ineligible patients, and treatment strategies that incorporate up-front allogeneic hematopoietic stem-cell transplantation and novel agents. RESULTS: As a result of lower-quality clinical evidence, a best practice approach was adopted and consensus statements agreed on by coauthors (> 90% agreement). CONCLUSION: This expert consensus highlights the need for additional clinical trials to develop novel standard therapies for the treatment of ATL.

authors

publication date

  • March 10, 2019

Research

keywords

  • Academic Article

Identity

Digital Object Identifier (DOI)

  • 10.1200/JCO.18.00501

PubMed ID

  • 30657736

Additional Document Info

start page

  • 677

end page

  • 687

volume

  • 37

number

  • 8