A multi-institutional experience of autologous stem cell transplantation in North American patients with human T-cell lymphotropic virus type-1 adult T-cell leukemia/lymphoma suggests ineffective salvage of relapsed patients

Phillips, Adrienne A.; Willim, Robert D.; Savage, David G.; Horwitz, Steven M.; Isola, Luis; Zain, Jasmine; O’Connor, Owen A.

doi:10.1080/10428190902887571

Cited by 23 publications

(14 citation statements)

References 15 publications

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“…The use of this regimen has been limited in the United States, and the National Comprehensive Cancer Network (NCCN) guidelines recommend regimens typically used in other non-Hodgkin lymphomas (NHL) such as CHOP, CHOEP, and dose-adjusted EPOCH [16]. While still not a standard of care, allogeneic hematopoietic stem cell transplantation can be considered [17–19], while the use of autologous stem cell transplantation is not recommended [17, 20]. …”

Section: Introductionmentioning

confidence: 99%

Adult T-cell leukemia/lymphoma in the Caribbean cohort is a distinct clinical entity with dismal response to conventional chemotherapy

et al. 2016

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Adult T-cell leukemia/lymphoma (ATLL) is a rare and aggressive disease caused by human T-cell lymphotropic virus type 1 that predominantly affects Japanese and Caribbean populations. Most studies have focused on Japanese cohorts. We conducted a retrospective analysis of 53 cases of ATLL who presented to our institution between 2003-2014. ATLL in the Caribbean population presents more often as the acute and lymphomatous subtypes, is associated with complex cytogenetics, and has a high rate of CNS involvement. The overall response rate to first-line therapies with anthracycline-based regimens was poor (32%), with a median survival of only 6.9 months. A complete or partial response to first-line regimens was associated with better survival. There was no difference in survival between patients who received chemotherapy alone versus chemotherapy with antiviral agents. Allogeneic transplantation was performed in five patients, two of whom achieved complete remission despite residual or refractory disease. Recipients of allogeneic transplantation had significantly improved overall survival compared to non-transplanted patients. This is the first analysis to describe ATLL pathological features, cytogenetics, and response to standard therapy and transplantation in the Caribbean cohort.

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Section: Introductionmentioning

confidence: 99%

Adult T-cell leukemia/lymphoma in the Caribbean cohort is a distinct clinical entity with dismal response to conventional chemotherapy

et al. 2016

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“…Monoclonal antibodies (anti-CD25, anti-CD4, anti-CD52, anti-CCR4, antitransferrin receptor) and novel agents (arsenic trioxide, bortezomib) have been tested in small numbers of patients and clinical trials are needed to better define the roles of these agents 47. There is little long-term benefit to autologous stem cell transplantation, although prolonged disease-free survival has been reported for allogeneic transplant in retrospective analyses 53,54…”

Section: Atllmentioning

confidence: 99%

An update on the management of peripheral T-cell lymphoma and emerging treatment options

Phillips¹,

Owens²,

Lee³

et al. 2011

JBM

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Peripheral T-cell lymphomas (PTCLs) comprise a rare and heterogeneous subset of non-Hodgkin’s lymphomas (NHLs) that arise from post-thymic T-cells or natural killer (NK)-cells at nodal or extranodal sites. Worldwide, PTCLs represent approximately 12% of all NHLs and the 2008 World Health Organization (WHO) classification includes over 20 biologically and clinically distinct T/NK-cell neoplasms that differ significantly in presentation, pathology, and response to therapy. Because of the rarity and heterogeneity of these diseases, large clinical trials have not been conducted and optimal therapy is not well defined. Most subtypes are treated with similar combination chemotherapy regimens as used for aggressive B-cell NHL, but with poorer outcomes. New treatment combinations and novel agents are currently being explored for PTCLs and this review highlights a number of options that appear promising.

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Section: Hsc Transplantationmentioning

confidence: 99%

“…High-dose chemotherapy and autologous HSCT has been reported in only a few ATL patients. 82,83 All patients relapsed or died from transplantation-related mortality, and this treatment strategy is not generally recommended.The initial case reports on the use of allogeneic HSCT in the treatment of ATL suggested potential efficacy but revealed a high toxicity and transplantation-related mortality up to 40% in these immunocompromised patients. The authors of several retrospective studies have confirmed that allogeneic HSCT with the use of either myeloablative conditioning [84][85][86] or reduced-intensity conditioning 87 conditioning as a promising treatment option for ATL patients.…”

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confidence: 99%

How I treat adult T-cell leukemia/lymphoma

Bazarbachi

Suarez

Fields

et al. 2011

Blood

146

151

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Adult T-cell leukemia/lymphoma (ATL) is an aggressive malignancy of mature activated T cells caused by human T-cell lymphotropic virus type I. ATL carries a bad prognosis because of intrinsic chemoresistance and severe immunosuppression. In acute ATL, Japanese trials demonstrated that although combinations of chemotherapy improved response rate, they failed to achieve a significant impact on survival. Patients with chronic and smoldering ATL have a better prognosis, but long-term survival is poor when these patients are managed with a watchfulwaiting policy or with chemotherapy. Recently, a worldwide meta-analysis revealed that the combination of zidovudine and IFN-␣ is highly effective in the leukemic subtypes of ATL and should be considered as standard first-line therapy in that setting. This combination has changed the natural history of the disease through achievement of significantly improved long-term survival in patients with smoldering and chronic ATL as well as a subset of patients with acute ATL. ATL lymphoma patients still benefit from chemotherapy induction with concurrent or sequential antiretroviral therapy with zidovudine/IFN. To prevent relapse, clinical trials assessing consolidative targeted therapies such as arsenic/IFN combination or novel monoclonal antibodies are needed. Finally, allogeneic BM transplantation should be considered in suitable patients. (Blood. 2011;118(7): 1736-1745) IntroductionAdult T-cell leukemia-lymphoma (ATL) is an aggressive lymphoid proliferation associated with the human lymphotropic virus type I (HTLV-I). 1,2 ATL usually occurs in people from HTLV-I-endemic regions, such as southern Japan, the Caribbean, Central and South America, intertropical Africa, Romania, and northern Iran. 3-6 HTLV-I causes transformation and clonal expansion of T cells, resulting in ATL in approximately 1%-4% of the estimated 10-20 million infected hosts, with a mean latency period of Ͼ 50 years. 3,5,7 PathogenesisThe serum of patients with ATL contains antibodies to HTLV-I, and the HTLV-I provirus is clonally integrated in most of the cases in the CD4 ϩ CD25 ϩ -activated T lymphocytes, which are the leukemic flower cells characteristic of ATL. The exact mechanism of HTLV-I-induced leukemogenesis is not fully elucidated, although HTLV-I infection appears to represent the first event of a multistep oncogenic process. 8 Oligoclonal expansions of HTLV-I-infected T cells result from expression of the viral transactivator protein Tax, which activates the viral promoter and various cellular genes, and also creates an autocrine loop involving IL-2, IL-15, and their cognate receptors. 9-12 Tax changes many cellular pathways, including activation of cAMP response element binding protein or cAMP-dependent transcription factor, adaptor-related protein complex 1, and NF-B; up-regulation of antiapoptotic proteins; repression of p53, DNA polymerase ␤, proliferating cell nuclear antigen, and the mitotic spindle-assembly checkpoint protein MAD1; and disruption of several cell-cycle regulators, including c...

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A multi-institutional experience of autologous stem cell transplantation in North American patients with human T-cell lymphotropic virus type-1 adult T-cell leukemia/lymphoma suggests ineffective salvage of relapsed patients

Cited by 23 publications

References 15 publications

Adult T-cell leukemia/lymphoma in the Caribbean cohort is a distinct clinical entity with dismal response to conventional chemotherapy

Adult T-cell leukemia/lymphoma in the Caribbean cohort is a distinct clinical entity with dismal response to conventional chemotherapy

An update on the management of peripheral T-cell lymphoma and emerging treatment options

How I treat adult T-cell leukemia/lymphoma

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