Katsuya Hiroo
Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1, Nabeshima, Saga, 849-8501, Japan.
Int J Hematol. 2023 Apr;117(4):512-522. doi: 10.1007/s12185-023-03572-4. Epub 2023 Mar 2.
Adult T-cell leukemia-lymphoma (ATL) is classified into four clinical subtypes: acute, lymphoma, chronic, and smoldering. Chronic ATL is further divided into unfavorable and favorable chronic types according to serum lactate dehydrogenase, blood urea nitrogen, and serum albumin values. Acute, lymphoma, and unfavorable chronic types are categorized as aggressive ATL, whereas favorable chronic and smoldering types are categorized as indolent ATL. Intensive chemotherapy alone is not sufficient to prevent relapse of aggressive ATL. Allogeneic hematopoietic stem cell transplantation is a potential therapeutic option to cure aggressive ATL in younger patients. Reduced-intensity conditioning regimens have decreased transplantation-related mortality, and increased donor availability has dramatically improved transplant access. New agents, including mogamulizumab, brentuximab vedotin, tucidinostat, and valemetostat, have recently become available for patients with aggressive ATL in Japan. Here, I provide an overview of recent advances in therapeutic strategies for ATL.
成人T细胞白血病-淋巴瘤（ATL）分为四种临床亚型：急性型、淋巴瘤型、慢性型和冒烟型。慢性ATL根据血清乳酸脱氢酶、血尿素氮和血清白蛋白值进一步分为不良慢性型和良好慢性型。急性型、淋巴瘤型和不良慢性型被归类为侵袭性ATL，而良好慢性型和冒烟型则被归类为惰性ATL。单纯强化化疗不足以预防侵袭性ATL的复发。异基因造血干细胞移植是治愈年轻患者侵袭性ATL的一种潜在治疗选择。降低强度的预处理方案降低了移植相关死亡率，供体来源的增加显著改善了移植途径。在日本，包括莫加莫单抗、维布妥昔单抗、图西司他和缬更昔洛韦在内的新型药物最近已可供侵袭性ATL患者使用。在此，我概述了ATL治疗策略的最新进展。
