Department of Psychiatry and Mental Health, Alborz University of Medical Sciences, Karaj, Iran.
Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
Virol J. 2023 Jun 7;20(1):118. doi: 10.1186/s12985-023-02077-0.
ATLL (Adult T-Cell Leukemia/Lymphoma) is an aggressive hematological malignancy. This T-cell non-Hodgkin lymphoma, caused by the human T-cell leukemia virus type 1 (HTLV-1), is challenging to treat. There is no known treatment for ATLL as of yet. However, it is recommended to use Zidovudine and Interferon Alfa-based regimens (AZT/IFN), chemotherapy, and stem cell transplant. This study aims to review the outcome of patients with different subtypes of ATLL treated with Zidovudine and Interferon Alfa-based regimens.
A systematic search was carried out for articles evaluating outcomes of ATLL treatment by AZT/IFN agents on human subjects from January 1, 2004, until July 1, 2022. Researchers assessed all studies regarding the topic, followed by extracting the data. A random-effects model was used in the meta-analyses.
We obtained fifteen articles on the AZT/IFN treatment of 1101 ATLL patients. The response rate of the AZT/IFN regimen yielded an OR of 67% [95% CI: 0.50; 0.80], a CR of 33% [95% CI: 0.24; 0.44], and a PR of 31% [95% CI: 0.24; 0.39] among individuals who received this regimen at any point during their treatment. Our subgroup analyses' findings demonstrated that patients who received front-line and combined AZT/IFN therapy responded better than those who received AZT/IFN alone. It is significant to note that patients with indolent subtypes of disease had considerably higher response rates than individuals with aggressive disease.
IFN/AZT combined with chemotherapy regimens is an effective treatment for ATLL patients, and its use in the early stages of the disease may result in a greater response rate.
成人 T 细胞白血病/淋巴瘤（Adult T-Cell Leukemia/Lymphoma，ATLL）是一种侵袭性血液系统恶性肿瘤。这种由人类 T 细胞白血病病毒 1 型（HTLV-1）引起的 T 细胞非霍奇金淋巴瘤难以治疗。目前尚无针对 ATLL 的已知治疗方法。然而，建议使用齐多夫定和干扰素α为基础的方案（AZT/IFN）、化疗和干细胞移植。本研究旨在回顾不同亚型 ATLL 患者接受以齐多夫定和干扰素α为基础的方案治疗的结果。
对 2004 年 1 月 1 日至 2022 年 7 月 1 日期间，人类接受 AZT/IFN 药物治疗 ATLL 的疗效评估文章进行了系统检索。研究人员评估了所有关于该主题的研究，然后提取数据。采用随机效应模型进行荟萃分析。
我们获得了 15 篇关于 AZT/IFN 治疗 1101 例 ATLL 患者的文章。AZT/IFN 方案的反应率为 67%[95%CI：0.50；0.80]，完全缓解率为 33%[95%CI：0.24；0.44]，部分缓解率为 31%[95%CI：0.24；0.39]，在接受该方案治疗的患者中。我们的亚组分析结果表明，接受一线和联合 AZT/IFN 治疗的患者比仅接受 AZT/IFN 治疗的患者反应更好。值得注意的是，患有惰性疾病亚型的患者的反应率明显高于患有侵袭性疾病的患者。
IFN/AZT 联合化疗方案是治疗 ATLL 患者的有效方法，在疾病早期使用可能会获得更高的反应率。
