Revised adult T-cell leukemia-lymphoma international consensus meeting report Guidelines


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.
Title: Revised adult T-cell leukemia-lymphoma international consensus meeting report
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.
Journal Title: Journal of Clinical Oncology
Volume: 37
Issue: 8
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2019-03-10
Start Page: 677
End Page: 687
Language: English
DOI: 10.1200/jco.18.00501
PUBMED: 30657736
PROVIDER: scopus
PMCID: PMC6494249
DOI/URL:
Notes: Article -- Export Date: 1 April 2019 -- Source: Scopus
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  1. Steven M Horwitz
    592 Horwitz