Interferon-alpha and antiretroviral agents: a treatment option for adult T-cell leukemia/lymphoma

Abstract

Adult T-cell leukemia/lymphoma (ATL) is a peripheral T-cell malignancy caused by human T-cell lymphotropic virus type I, and its clinical subtypes are categorized into smoldering, chronic, lymphoma and acute types. The standard care for patients with the acute, lymphoma and unfavorable chronic types (aggressive ATL) consists of intensive chemotherapy with or without subsequent allogeneic hematopoietic stem cell transplant, or a combination of interferon alfa and an antiretroviral agent, while that for the chronic type without unfavorable prognostic factors and the smoldering type (indolent ATL) is watchful waiting. Recently, early intervention for indolent ATL employing interferon alfa and an antiretroviral agent has been reported to lead to a marked benefit in a retrospective study. This modality should be evaluated in larger clinical trials, since patients with indolent ATL show a median survival time of as short as 4-5 years.