Striving to cure adult T-cell leukaemia/lymphoma: a role for allogeneic stem cell transplant?
Adult T-cell leukaemia/lymphoma (ATL) is an aggressive HTLV-1-related malignancy, rare outside of regions where the retrovirus is endemic. Although the use of antiviral therapy has improved outcomes, particularly for indolent forms of ATL, response to combination chemotherapy is poor and outcomes for aggressive subtypes remains dismal. Consolidation with allogeneic stem cell transplant (alloSCT) has an increasing role in the management of ATL in eligible patients, offering favourable long-term remission rates. However, relatively high-transplant-related mortality and issues with donor recruitment for certain ethnicities remain problematic. In this review, we discuss the rationale for and issues surrounding alloSCT in ATL in the context of conventional and emerging therapies.
Department of Haematology, University College Hospital, London, UK.
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EH
Phillips
Department of Haematology, Ipswich Hospital, Ipswich, UK.
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A
Hodson
Department of Hematology, Imagine Institute, Assistance Publique Hôpitaux de Paris, Paris Descartes University, Necker Hospital, Paris, France.
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O
Hermine
Department of Internal Medicine, American University of Beirut, Medical Center, Beirut, Lebanon.
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A
Bazarbachi
Department of Haematology, University College Hospital, London, UK.
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Cwynarski
D000328:Adult; D003131:Combined Modality Therapy; D015368:Human T-lymphotropic virus 1 / Q000187:drug effects; D006801:Humans; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000401:mortality / Q000628:therapy*; D033581:Stem Cell Transplantation / Q000379:methods*; D016896:Treatment Outcome