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Leukemia Research and Treatment
Volume 2012 (2012), Article ID 932175, 8 pages
http://dx.doi.org/10.1155/2012/932175
Review Article

Clinical Trials of Adult T-Cell Leukaemia/Lymphoma Treatment

1Department of Hematology, Necker Hospital, 75473 Paris Cedex 15, France
2Department of Internal Medicine, American University of Beirut, Beirut, Lebanon

Received 5 October 2011; Accepted 11 November 2011

Academic Editor: Kunihiro Tsukasaki

Copyright © 2012 Ambroise Marçais et al. 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.

Abstract

Adult T-cell leukaemia/lymphoma (ATLL) is an aggressive malignancy of mature activated T cells caused by human T-cell lymphotropic virus type I (HTLV-1). Prognosis is severe because of intrinsic chemoresistance and severe immuosuppression. Four different subtypes are described with different outcomes, and treatment strategies vary according to the different clinical courses. Japanese trials show that combinations of chemotherapy can increase the response rates especially in the lymphoma subtype. However, patients have a high rate of relapse and the outcome remains extremely poor. Recently, a worldwide meta-analysis demonstrated that the combination of Zidovudine and Interferon-alpha (IFN) is effective in the leukemic subtypes (smoldering, chronic, and acute) and influences favorably the course of the disease. In order to prevent relapse, clinical trials testing new drugs such as monoclonal antibodies or combinations such as arsenic/IFN are needed. Finally, allogeneic stem cell transplantation is a feasible option but bears a very high rate of complications.