Adult T-Cell Leukemia/Lymphoma: Treatment Options

Depending on the Adult T-cell leukemia/lymphoma (ATLL)  subtype, the following treatment options are available:

Slow-growing Subtypes of ATLL

For some patients who have one of the slower-growing subtypes of ATLL with mild or no symptoms, observation without active treatment which is known as “active surveillance” (also known as “watch and wait” or “watchful waiting”), may be appropriate. During this period, regular follow-up with your healthcare team is required. For ATLL affecting the skin, skin-directed therapies (such as, topical steroids or local radiation) may be prescribed.

Aggressive Subtypes of ATLL

For patients with a more aggressive subtype, active treatment is needed.  Common first-line (initial) chemotherapies used to treat ATLL are the same as those used to treat other types of T-cell lymphomas. These include:

• CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone)
• CHOEP (cyclophosphamide, doxorubicin, vincristine, etoposide and prednisone)
• Dose-adjusted EPOCH (etoposide, vincristine, doxorubicin, cyclophosphamide and prednisone)
• Hyper-CVAD (cyclophosphamide, vincristine, doxorubicin, and dexamethasone)

Treatments Under Investigation for ATLL

Several new drugs are being studied in clinical trials for ATLL, as single-agent therapy or as part of a combination therapy regimen, including the following:

• Belinostat (Beleodaq)
• Bendamustine (Treanda)
• BL-8040
• Bortezomib (Velcade)
• Brentuximab vedotin (Adcetris)
• CPI-613

• Mogamulizumab (Poteligeo; approved in Japan for relapsed/refractory ATLL)
• Nelarabine (Arranon)
• Nivolumab (Opdivo)
• Romidepsin (Istodax)
• Ruxolitinib (Jakafi)

High-dose chemotherapy followed by allogeneic stem cell transplantation (in which patients receive stem cells from a donor) is also being evaluated as a potential treatment for patients with ATLL. It is critical to remember that today’s scientific research is continuously evolving. Treatment options may change as new treatments are discovered and current treatments are improved. Therefore, it is important that patients check with their physician or with the Lymphoma Research Foundation (LRF) for any treatment updates that may have recently emerged.

To learn about treatments under investigation for ATLL, download the Adult T-Cell Leukemia/Lymphoma Fact Sheet.