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

Lucy B. Cook, Shigeo Fuji, Olivier Hermine, Ali Bazarbachi, Juan Carlos Ramos, Lee Ratner, Steve Horwitz, Paul Fields, Alina Tanase, Horia Bumbea, Kate Cwynarski, Graham Taylor, Thomas A. Waldmann, Achilea Bittencourt, Ambroise Marcais, Felipe Suarez, David Sibon, Adrienne Phillips, Matthew Lunning, Reza FaridYoshitaka Imaizumi, Ilseung Choi, Takashi Ishida, Kenji Ishitsuka, Takuya Fukushima, Kaoru Uchimaru, Akifumi Takaori-Kondo, Yoshiki Tokura, Atae Utsunomiya, Masao Matsuoka, Kunihiro Tsukasaki, Toshiki Watanabe

Research output: Contribution to journalArticle

21 Scopus citations

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

Original languageEnglish (US)
Pages (from-to)677-687
Number of pages11
JournalJournal of Clinical Oncology
Volume37
Issue number8
DOIs
StatePublished - Mar 10 2019

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    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., ... Watanabe, T. (2019). Revised adult T-cell leukemia-lymphoma international consensus meeting report. Journal of Clinical Oncology, 37(8), 677-687. https://doi.org/10.1200/JCO.18.00501