From Genomic and Epigenomic Maps to Medicines in Adult T-Cell Leukemia/Lymphoma

Adult T-cell leukemia/lymphoma (ATL) is an aggressive and refractory hematologic malignancy that is caused by human T-cell leukemia virus type-1 (HTLV-1) retrovirus. ATL results from a combination of viral latency and the accumulation of abnormalities throughout the genome, epigenome, transcriptome, and signaling pathways. Despite numerous studies, the data have been largely fragmentary, and a comprehensive understanding of this disease remains unclear. Recent comprehensive analyses have contributed not only to the identification of fundamental molecular abnormalities in ATL, but also to the development of novel therapeutic strategies and prognostic models. In this review, an overview of the latest advances in the genomic, epigenomic, and transcriptomic alterations associated with ATL is provided, which highlights the opportunities for clinical management of ATL. Integrated omics approaches will further increase our understanding of refractory disease and provide a foundation for designing new treatments that target core molecular drivers.