Cutaneous type adult T‐cell leukemia/lymphoma is a characteristic subtype and includes erythema/papule and nodule/tumor subgroups

Miyata, Tomoko; Yonekura, Kentaro; Utsunomiya, Atae; Kanekura, Takuro; Nakamura, Shigeo; Seto, Masao

doi:10.1002/ijc.24874

Cited by 11 publications

(5 citation statements)

References 18 publications

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“…Electron beam irradiation is also effective for a solitary skin nodules. 13 For cutaneous type ATL, 5,6 generalized erythema/papule and nodule/tumor are usually treated with topical corticosteroids ointment or PUVA therapy, electron beam irradiation or surgical operation or the same multiagents conventional chemotherapy as for lymphoma type ATL, respectively.…”

Section: Smoldering and Favorable Chronic Typesmentioning

confidence: 99%

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Treatment of Adult T-cell Leukemia

Uozumi

2010

J Clin Exp Hematopathol

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Adult T-cell Leukemia (ATL) is an aggressive malignant disease of CD4 + T-cells associated with human T-cell leukemia virus type I (HTLV-I). Prognosis of ATL patients is directly correlated to the subtype of ATL. Treatment of the aggressive forms (acute and lymphoma types) of ATL remains inadequate, as most ATL patients receive conventional chemotherapy without stem cell rescue. At present, LSG15 is the standard chemotherapy for the treatment of aggressive ATL, but the efficacy of LSG15 in most patients is transient. To prolong median survival time, additional therapies for maintenance of complete response (CR) are needed after achieving CR by induction chemotherapy. Improved outcome after allogeneic stem cell transplantation (allo-SCT), despite a high incidence of graft-versus-host disease, has been reported. Thus, allogeneic bone marrow transplantation and allogeneic peripheral blood SCT may have great potential for eradication of HTLV-1 and cure of ATL. Recently, reduced-intensity conditioning stem cell transplantation was also reported to be effective for ATL. Although several issues, including selection criteria for patients and sources of stem cells remain to be resolved, allo-SCT may be considered as a treatment option for patients with aggressive ATL. To evaluate whether allo-SCT is more effective than the standard chemotherapy (LSG15) for aggressive ATL, an upfront phase II clinical trial of JCOG-LSG is now being planned. Novel innovative targeted strategies, such as antiretroviral therapy, arsenic trioxide, nuclear factor-kB inhibitors, proteasome inhibitors, histone deacetylase inhibitors, several monoclonal antibodies including anti-CC chemokine receptor 4, anti-folate, purine nucleotide phosphorylase inhibitor, mTOR (mammalian target of rapamycin) inhibitor, bendamustine, small molecule Bcl-2 inhibitors and Tax-targeted immunotherapy, should be promptly studied in order to develop curative treatments for ATL in the near future. 〔J Clin Exp Hematopathol 50(1) : 9-25, 2010〕

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Section: Smoldering and Favorable Chronic Typesmentioning

confidence: 99%

“…4 However, a fifth subtype, cutaneous type ATL was recently reported. 5,6 Prognosis of ATL patients is directly correlated with the subtype of ATL.…”

Section: Introductionmentioning

confidence: 99%

Treatment of Adult T-cell Leukemia

Uozumi

2010

J Clin Exp Hematopathol

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“…The designation cutaneous type ATL has been proposed to describe patients with the smoldering type in whom the skin is predominantly affected because these patients exhibit a peculiar clinical course and require treatment that is different from the management of smoldering type ATL without skin lesions (the type we designated non‐cutaneous smoldering type). Elsewhere, we reported our genomic profile analysis using the array comparative genomic hybridization method that showed that many patients with cutaneous type ATL manifested chromosomal aberrations, for example gains of 1p, 7q and 18q, and loss of 13q . Based on those findings we compared the HTLV‐1 proviral load in cutaneous and non‐cutaneous smoldering type ATL; we found that it is significantly lower in the cutaneous type.…”

Section: Discussionmentioning

confidence: 93%

Human T‐lymphotropic virus type I proviral loads in patients with adult T‐cell leukemia–lymphoma: Comparison between cutaneous type and other subtypes

Yonekura

Utsunomiya

Seto

et al. 2015

The Journal of Dermatology

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Adult T-cell leukemia-lymphoma (ATL), characterized by various clinicopathological features, is divided into four clinical subtypes, namely, acute, lymphoma, chronic and smoldering types, and the treatment strategy differs according to the clinical subtype. The designation cutaneous type ATL has been proposed to describe a peculiar subgroup of smoldering type ATL in which the skin is predominantly affected. However, diagnostic criteria and prognostic factors for cutaneous type ATL remain to be determined. Therefore, we performed a retrospective study to obtain a precise method for subtype classification and to clearly define cutaneous type ATL. A total of 87 ATL patients (acute, n = 31; lymphoma, n = 6; chronic, n = 24; smoldering, n = 26) were enrolled. The human T-lymphotropic virus type I (HTLV-1) proviral load in peripheral blood and the serum soluble interleukin-2 receptor (sIL-2R) level were evaluated with respect to the clinical features of the different types of ATL. The HTLV-1 proviral load was significantly increased in the acute and chronic type and the serum sIL-2R level was increased in the acute and lymphoma type. The HTLV-1 proviral load was significantly lower in cutaneous than other smoldering types of ATL without skin lesions. The clinical findings of cutaneous type ATL were also different from other subtypes. These results indicate that, in combination, determination of the HTLV-1 proviral load and the serum sIL-2R level is useful for distinguishing among the different types of ATL, and strongly suggest that cutaneous type ATL is a distinct clinical entity.

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“…6 Adult T cell leukemia/lymphoma with only skin manifestations is sometimes referred to as cutaneous-type ATLL. [7][8][9] The cutaneous type is subdivided into tumoral and erythematopapular subtypes with a prognostic difference: median survival is 19 months in the former subtype and 60 months in the latter. 7 Miyata et al 8 reported that genomic gains of 1p, 7q and 18q and loss of 13q were frequently detected in cutaneous ATLL and a gain of 1p36.33-32 or loss of 13q33.1-3 indicated a poor prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…It has also been reported that patients with smoldering ATLL with skin manifestations may have a worse prognosis than those without . Adult T cell leukemia/lymphoma with only skin manifestations is sometimes referred to as cutaneous‐type ATLL . The cutaneous type is subdivided into tumoral and erythematopapular subtypes with a prognostic difference: median survival is 19 months in the former subtype and 60 months in the latter .…”

Section: Discussionmentioning

confidence: 99%