Adult T-cell leukemia/lymphoma.

Area of Science:

• Oncology
• Virology
• Hematology

Background:

• Adult T-cell leukemia/lymphoma (ATL) is a mature CD4+ T-cell malignancy linked to human T-cell lymphotropic virus type 1 (HTLV-1).
• HTLV-1 infection is widespread globally, with significant prevalence in Japan, Africa, the Caribbean, and South America, notably Brazil and Peru.
• ATL manifests in various clinical forms, including acute, lymphoma, chronic, and smoldering, affecting approximately 5% of infected individuals.

Purpose of the Study:

• To review the clinical, hematological, and pathological aspects of ATL.
• To disseminate information on ATL diagnosis and therapy, particularly in regions like Brazil where the disease is less understood.
• To highlight the critical role of clinical classification in determining ATL prognosis and guiding therapeutic strategies.

Main Methods:

• This study is a review paper synthesizing existing literature on ATL.
• Information was gathered on clinical presentations, diagnostic criteria, and treatment modalities for ATL.
• Epidemiological data on HTLV-1 infection and ATL prevalence were also reviewed.

Main Results:

• ATL exhibits diverse clinical forms, ranging from aggressive to smoldering, with some cases showing prolonged progression.
• Clinical classification is crucial for accurate prognosis and selection of appropriate treatment.
• Effective prevention strategies, such as interrupting HTLV-1 transmission through breastfeeding, are essential for reducing ATL incidence.

Conclusions:

• Accurate clinical classification of ATL is vital for patient management and therapeutic decision-making.
• Further dissemination of knowledge regarding ATL's clinical, diagnostic, and therapeutic aspects is necessary, especially in underrepresented regions.
• Preventing HTLV-1 transmission, particularly mother-to-child transmission via breastfeeding, represents the most effective approach to control ATL occurrence.