TY - JOUR
T1 - Long-term clinical remission maintained after cessation of zidovudine and interferon-α therapy in chronic adult T-cell leukemia/lymphoma
AU - Cook, Lucy B.
AU - Rowan, Aileen G.
AU - Demontis, Maria A.
AU - Sagawe, Sophie
AU - Gillet, Nicolas A.
AU - Melamed, Anat
AU - Greiller, Claire
AU - Witkover, Aviva
AU - Bangham, Charles R.M.
AU - Taylor, Graham P.
PY - 2018/3/1
Y1 - 2018/3/1
N2 - © 2017 The Japanese Society of Hematology Globally, > 5–10 million people are estimated to be infected with Human T-lymphotropic virus type 1 (HTLV-1), of whom ~ 5% develop adult T-cell leukemia/lymphoma (ATL). Despite advances in chemotherapy, overall survival (OS) has not improved in the 35 years since HTLV-1 was first described. In Europe/USA, combination treatment with zidovudine and interferon-α (ZDV/IFN-α) has substantially changed the management of patients with the leukemic subtypes of ATL (acute or unfavorable chronic ATL) and is under clinical trial evaluation in Japan. However, there is only a single published report of long-term clinical remission on discontinuing ZDV/IFN-α therapy and the optimal duration of treatment is unknown. Anecdotal cases where therapy is discontinued due to side effects or compliance have been associated with rapid disease relapse, and it has been widely accepted that the majority of patients will require life-long therapy. The development of molecular methods to quantify minimal residual disease is essential to potentially guide therapy for individual patients. Here, for the first time, we report molecular evidence that supports long-term clinical remission in a patient who was previously treated with ZDV/IFN-α for 5 years, and who has now been off all therapy for over 6 years.
AB - © 2017 The Japanese Society of Hematology Globally, > 5–10 million people are estimated to be infected with Human T-lymphotropic virus type 1 (HTLV-1), of whom ~ 5% develop adult T-cell leukemia/lymphoma (ATL). Despite advances in chemotherapy, overall survival (OS) has not improved in the 35 years since HTLV-1 was first described. In Europe/USA, combination treatment with zidovudine and interferon-α (ZDV/IFN-α) has substantially changed the management of patients with the leukemic subtypes of ATL (acute or unfavorable chronic ATL) and is under clinical trial evaluation in Japan. However, there is only a single published report of long-term clinical remission on discontinuing ZDV/IFN-α therapy and the optimal duration of treatment is unknown. Anecdotal cases where therapy is discontinued due to side effects or compliance have been associated with rapid disease relapse, and it has been widely accepted that the majority of patients will require life-long therapy. The development of molecular methods to quantify minimal residual disease is essential to potentially guide therapy for individual patients. Here, for the first time, we report molecular evidence that supports long-term clinical remission in a patient who was previously treated with ZDV/IFN-α for 5 years, and who has now been off all therapy for over 6 years.
KW - Chronic ATL
KW - HTLV
KW - Zidovudine/interferon-α
UR - http://www.scopus.com/inward/record.url?scp=85032692304&partnerID=8YFLogxK
UR - http://www.mendeley.com/research/longterm-clinical-remission-maintained-after-cessation-zidovudine-interferon%CE%B1-therapy-chronic-adult
U2 - 10.1007/s12185-017-2361-7
DO - 10.1007/s12185-017-2361-7
M3 - Article
AN - SCOPUS:85032692304
VL - 107
SP - 378
EP - 382
JO - International Journal of Hematology
JF - International Journal of Hematology
SN - 0925-5710
IS - 3
ER -