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Clinical Trials and Treatment of ATL

ATL is a distinct peripheral T-lymphocytic malignancy associated with 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 subtype-classification into four categories, acute, lymphoma, chronic, and smoldering t...

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Autores principales: Tsukasaki, Kunihiro, Tobinai, Kensei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3505932/
https://www.ncbi.nlm.nih.gov/pubmed/23259064
http://dx.doi.org/10.1155/2012/101754
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author Tsukasaki, Kunihiro
Tobinai, Kensei
author_facet Tsukasaki, Kunihiro
Tobinai, Kensei
author_sort Tsukasaki, Kunihiro
collection PubMed
description ATL is a distinct peripheral T-lymphocytic malignancy associated with 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 subtype-classification into four categories, acute, lymphoma, chronic, and smoldering types, defined by organ involvement, and LDH and calcium values. In case of acute, lymphoma, or unfavorable chronic subtypes (aggressive ATL), intensive chemotherapy like the LSG15 regimen (VCAP-AMP-VECP) is usually recommended if outside of clinical trials, based on the results of a phase 3 trial. In case of favorable chronic or smoldering ATL (indolent ATL), watchful waiting until disease progression has been recommended, although the long-term prognosis was inferior to those of, for instance, chronic lymphoid leukemia. Retrospective analysis suggested that the combination of interferon alpha and zidovudine was apparently promising for the treatment of ATL, especially for types with leukemic manifestation. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is also promising for the treatment of aggressive ATL possibly reflecting graft versus ATL effect. Several new agent trials for ATL are ongoing and in preparation, including a defucosylated humanized anti-CC chemokine receptor 4 monoclonal antibody, IL2-fused with diphtheria toxin, histone deacetylase inhibitors, a purine nucleoside phosphorylase inhibitor, a proteasome inhibitor, and lenalidomide.
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spelling pubmed-35059322012-12-20 Clinical Trials and Treatment of ATL Tsukasaki, Kunihiro Tobinai, Kensei Leuk Res Treatment Review Article ATL is a distinct peripheral T-lymphocytic malignancy associated with 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 subtype-classification into four categories, acute, lymphoma, chronic, and smoldering types, defined by organ involvement, and LDH and calcium values. In case of acute, lymphoma, or unfavorable chronic subtypes (aggressive ATL), intensive chemotherapy like the LSG15 regimen (VCAP-AMP-VECP) is usually recommended if outside of clinical trials, based on the results of a phase 3 trial. In case of favorable chronic or smoldering ATL (indolent ATL), watchful waiting until disease progression has been recommended, although the long-term prognosis was inferior to those of, for instance, chronic lymphoid leukemia. Retrospective analysis suggested that the combination of interferon alpha and zidovudine was apparently promising for the treatment of ATL, especially for types with leukemic manifestation. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is also promising for the treatment of aggressive ATL possibly reflecting graft versus ATL effect. Several new agent trials for ATL are ongoing and in preparation, including a defucosylated humanized anti-CC chemokine receptor 4 monoclonal antibody, IL2-fused with diphtheria toxin, histone deacetylase inhibitors, a purine nucleoside phosphorylase inhibitor, a proteasome inhibitor, and lenalidomide. Hindawi Publishing Corporation 2012 2012-01-16 /pmc/articles/PMC3505932/ /pubmed/23259064 http://dx.doi.org/10.1155/2012/101754 Text en Copyright © 2012 K. Tsukasaki and K. Tobinai. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Tsukasaki, Kunihiro
Tobinai, Kensei
Clinical Trials and Treatment of ATL
title Clinical Trials and Treatment of ATL
title_full Clinical Trials and Treatment of ATL
title_fullStr Clinical Trials and Treatment of ATL
title_full_unstemmed Clinical Trials and Treatment of ATL
title_short Clinical Trials and Treatment of ATL
title_sort clinical trials and treatment of atl
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3505932/
https://www.ncbi.nlm.nih.gov/pubmed/23259064
http://dx.doi.org/10.1155/2012/101754
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