Experience in the management of patients with HTLV-1 positive adult T-cell leukemia/lymphoma in a Latin American center

Background: Adult T-cell leukemia/lymphoma (ATL) is a neoplasm with a high prevalence in certain regions such as southwestern Japan, the Caribbean, sub-Saharan Africa, South America, and Australia. In Colombia, the seroprevalence of human T-cell lymphotropic virus type 1 (HTLV-1) has been reported i...

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Main Authors: Danielle Floyd-Aristizábal, Cristian Alonso Barreiro García, Oriana Arias-Valderrama, Catalina Proaño Millán, Nhora María Silva Perez, Joaquín Donaldo Rosales Martinez, Elizabeth Arrieta López
Format: Article
Language:English
Published: SAGE Publishing 2025-02-01
Series:Therapeutic Advances in Hematology
Online Access:https://doi.org/10.1177/20406207251316178
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Summary:Background: Adult T-cell leukemia/lymphoma (ATL) is a neoplasm with a high prevalence in certain regions such as southwestern Japan, the Caribbean, sub-Saharan Africa, South America, and Australia. In Colombia, the seroprevalence of human T-cell lymphotropic virus type 1 (HTLV-1) has been reported in specific populations, but there is limited information about the clinical course and management of ATL in the country. Objectives: To describe the clinical characteristics, treatment patterns, and outcomes of patients diagnosed with HTLV-1-positive ATL in a high-complexity healthcare institution in Colombia and compare these findings with reports from other geographic regions. Design: Observational retrospective cohort study conducted in a single high-complexity healthcare institution in Cali, Colombia, including patients diagnosed between 2011 and January 2022. Methods: This study presents an observational retrospective cohort of patients diagnosed with HTLV-1-positive ATL and managed at a high-complexity institution in Cali, Colombia. Eligible patients were adults diagnosed with ATL and HTLV-1 seropositivity, receiving treatment between 2011 and January 2022. Demographic, clinical, and treatment-related variables were collected and analyzed using descriptive and survival analyses. Results: Thirty-three patients diagnosed with ATL between 2011, and January 2022 were identified and included in the study. Most patients were female (52%) with a median age of 54 years. Acute presentation was the most common (64%), and most patients were identified at Ann Arbor stage 4. Treatment mainly consisted of various chemotherapy protocols, with cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and prednisone (CHOP)-like regimens being the most frequently used. However, the overall response rate to chemotherapy was low, and most patients experienced complications and toxicities associated with treatment. Conclusion: This study provides insights into the clinical course and management of ATL in a Colombian population. The findings highlight the predominance of acute presentations, advanced disease stages at diagnosis, and challenges in achieving a complete response with conventional chemotherapy. Further research is needed to improve treatment strategies, identify prognostic markers, and develop more effective therapies for ATL patients in Colombia.
ISSN:2040-6215