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Cited by 267T-cell and Retrovirus StudiesViral-associated cancers and disordersCutaneous lymphoproliferative disorders research

Revised Adult T-Cell Leukemia-Lymphoma International Consensus Meeting Report

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Cook, Lucy B., Fuji, Shigeo, Hermine, Olivier, Bazarbachi, Ali, Ramos, Juan Carlos, Ratner, Lee, Horwitz, Steve, Fields, Paul +24 more·2019·Journal of Clinical Oncology
DOI 10.1200/jco.18.00501PMC PMC6494249
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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

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  • AZT/IFN-α is not currently approved for ATL treatment in Japan, despite being the worldwide standard for acute, chronic, smouldering symptomatic and PCT-ATL subtypes.

    “AZT/IFN-α is not currently approved for ATL treatment in Japan, despite being the worldwide standard for acute, chronic, smouldering symptomatic and PCT-ATL subtypes [194].”

    From Current State of Therapeutics for HTLV-1 (2024) · cites this paper as [194]

    The Introduction (page not provided) states that zidovudine and interferon-alpha are not approved in Japan but can be used elsewhere. The sections on aggressive ATL and the primary cutaneous variant (pages not provided) present AZT/IFN as a treatment option, not the worldwide standard for every listed subtype; the cutaneous-variant section also offers intensive chemotherapy. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Aggressive forms of ATL are treated with intensive chemotherapy, coupled with concurrent or low-dose azidothymidine and interferon-alpha (AZT/IFN-α) for maintenance.

    “Aggressive forms of ATL are treated with intensive chemotherapy, coupled with concurrent or low-dose azidothymidine, an NRTI developed for HIV-AIDS, and interferon-alpha (AZT/IFN-α) for maintenance [194].”

    From Current State of Therapeutics for HTLV-1 (2024) · cites this paper as [194]

    The ‘ALLO-HSCT FOR AGGRESSIVE ATL’ section describes intensive chemotherapy and AZT/IFN as treatment options for aggressive ATL, but does not say they are routinely given together. The ‘ELDERLY AND NON–TRANSPLANTATION-SUITABLE PATIENTS WITH AGGRESSIVE ATL’ consensus statement allows AZT/IFN maintenance after less-intensive induction in selected patients; it does not establish concurrent AZT/IFN with intensive chemotherapy or specify low-dose AZT/IFN maintenance. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

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Cited by

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  • Current State of Therapeutics for HTLV-1

    Wang, T. T., Hirons, A., Doerflinger, M., Morris, K. V., Ledger, S., Purcell, D. F. J., Kelleher, A. D., & Ahlenstiel, C. L. (2024) · Viruses · doi:10.3390/v16101616 · Cited by 22 · see citing works

    “Lesser-known medical burdens of HTLV-1 infection extend beyond this list, as patients report experiencing non-specific neuropathic/non-neuropathic pain alongside infection [262].”
    BackgroundResultInfluential

Authors
Cook, L. B., Fuji, S., Hermine, O., Bazarbachi, A., Ramos, J. C., Ratner, L., Horwitz, S., Fields, P., Tanase, A., Bumbea, H., Cwynarski, K., Taylor, G., Waldmann, T. A., Bittencourt, A., Marcais, A., Suarez, F., Sibon, D., Phillips, A., Lunning, M., Farid, R., Imaizumi, Y., Choi, I., Ishida, T., Ishitsuka, K., Fukushima, T., Uchimaru, K., Takaori-Kondo, A., Tokura, Y., Utsunomiya, A., Matsuoka, M., Tsukasaki, K., & Watanabe, T.
Affiliations
  • National Health Service (GB)
  • Osaka International Cancer Institute (JP)
  • Hôpital Necker-Enfants Malades (FR)
  • American University of Beirut (LB)
  • University of Miami (US)
  • Washington University in St. Louis (US)
  • Memorial Sloan Kettering Cancer Center (US)
  • St Thomas' Hospital (GB)
  • Fundeni Clinical Institute, Bucharest, Romania
  • Clinical Emergency Hospital Bucharest (RO)
  • University College London (GB)
  • Imperial College London (GB)
  • National Institutes of Health (US)
  • Universidade Federal da Bahia, Salvador, Brazil
  • Necker University Hospital, Paris, France
  • Weill Cornell Medicine (US)
  • University of Nebraska at Omaha (US)
  • Mashhad University of Medical Sciences (IR)
  • Nagasaki University (JP)
  • National Hospital Organization Kyushu Cancer Center (JP)
  • Iwate Medical University (JP)
  • Kagoshima University Hospital (JP)
  • University of the Ryukyus (JP)
  • The University of Tokyo (JP)
  • Kyoto University, Kyoto, Japan
  • Hamamatsu University (JP)
  • Imamura Hospital (JP)
  • Kumamoto University (JP)
  • Saitama Medical University (JP)
Corresponding author
Tsukasaki, Kunihiro
ORCID
Venue
Journal of Clinical Oncology
Publisher
American Society of Clinical Oncology (ASCO)
Published
2019-03-10
Volume
37
Issue
8
Pages
677-687
ISSN
  • 0732-183X (ISSN-L)
  • 1527-7755
DOI
10.1200/jco.18.00501
PMC
PMC6494249
OpenAlex
W2909144857
Cited by
267
References
2
Citations by year
2026: 21 · 2025: 43 · 2024: 26 · 2023: 35 · 2022: 35 · 2021: 50 · 2020: 40 · 2019: 17
FWCI
14.19
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Journal of Clinical Oncology (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Spiral (Imperial College London) (submittedVersion, cc-by)
Funders
  • Japan Agency for Medical Research and Development (JP18ck0106338)
  • National Institute for Health and Care Research
  • National Institutes of Health (CA008748)
  • Japan Society for the Promotion of Science (16H04713, 16H05248, 16H06277)
  • National Cancer Institute (CA008748, R21CA234640, P30CA008748)
Topics
  • Life Sciences › Immunology and Microbiology › Immunology › T-cell and Retrovirus Studies
  • Health Sciences › Medicine › Oncology › Viral-associated cancers and disorders
  • Health Sciences › Medicine › Dermatology › Cutaneous lymphoproliferative disorders research
Keywords
adult T-cell leukemia/lymphoma, HTLV-1, cutaneous T-cell lymphoma, central nervous system lesions, elderly patients, allogeneic hematopoietic stem cell transplantation, novel agents, prognostic factors, treatment options, response criteria, molecular pathophysiology
MeSH terms
Antineoplastic Agents, Humans, Medical Oncology, Risk Factors, Skin Neoplasms, Transplantation, Homologous, Human T-lymphotropic virus 1, Leukemia-Lymphoma, Adult T-Cell, Central Nervous System Neoplasms, Treatment Outcome, Hematopoietic Stem Cell Transplantation, Consensus

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