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Can we cure HTLV-I associated Adult T cell Leukemia Lymphoma?

Authors
Journal
Retrovirology
1742-4690
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Volume
8
Identifiers
DOI: 10.1186/1742-4690-8-s1-a37
Keywords
  • Meeting Abstract
Disciplines
  • Biology
  • Medicine

Abstract

Can we cure HTLV-I associated Adult T cell Leukemia Lymphoma? MEETING ABSTRACT Open Access Can we cure HTLV-I associated Adult T cell Leukemia Lymphoma? Ali Bazarbachi1*, Felipe Suarez2, Olivier Hermine2 From 15th International Conference on Human Retroviruses: HTLV and Related Viruses Leuven and Gembloux, Belgium. 5-8 June 2011 Adult T cell leukemia (ATL) is one of the rare human cancers initiated by a transforming retrovirus, HTLV- I. After many years of controversy, it is now accepted that the viral transactivator protein Tax plays a criti- cal role in initiating the leukemic process, because Tax transgenics develop a disease with striking ATL features. However, its role in the maintenance of the lymphoproliferation remains still a matter of debate. Long-term prognosis of ATL patients remains extre- mely poor. In acute ATL, well conducted 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 watchful-waiting policy or with che- motherapy. We recently realized a worldwide meta- analysis showing that the combination of zidovudine and interferon-alpha (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 patients with acute ATL and wild type p53. ATL lymphoma patients may benefit from initial induction therapy based on aggressive chemotherapy regimen in addition to or followed by antiretroviral therapy with AZT/IFN. In all patients, in order to prevent the occurrence of resistance and relapse, clinical trials assessing bone marrow trans- plantation additional targeted therapies such as arsenic/

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