What Is the Treatment of Symptomatic Smouldering or Chronic Adult T-cell Leukaemia-Lymphoma?
Clinical Scenario
This protocol applies to adult T-cell leukaemia-lymphoma (ATLL) presenting in any of the following specific situations:
- Symptomatic smouldering ATLL — with skin lesions, lung lesions, or opportunistic infections
- Primary cutaneous ATLL with tumoural skin lesions
- Chronic ATLL
Treatment Approach (partial overview)
For relapsed or refractory disease in these presentations, management may involve systemic monotherapy guided by the tumour's receptor expression profile, or allogeneic stem-cell transplantation in suitable responding patients — among other options. The complete decision pathway, agent selection criteria, and sequencing are defined in the full structured protocol.
Full regimen, eligibility criteria, and treatment algorithm available via the link below.
References
DOI: 10.1016/j.annonc.2025.01.023
- Zidovudine-interferon-a (IFN-a) can be recommended for patients with symptomatic smouldering (skin or lung lesions, opportunistic infections), primary cutaneous with tumoural lesions or chronic ATLL [III, B; not EMA or FDA approved], along with skin-directed therapy in case of skin lesions [III, B].
- Monotherapy with mogamulizumab (if CCR4-positive; not EMA or FDA approved), BV (if CD30-positive; not EMA or FDA approved), alemtuzumab (if CD52-positive; not EMA or FDA approved) or lenalidomide (not EMA or FDA approved) can be considered [III, B].
- Allo-HSCT (if not used in first line) should be considered in HSCT-eligible responding patients [III, A].
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