HTLV-1 Reactivation in Adult T-Cell Leukemia-Lymphoma Treatment
Author Information
Author(s): Lee Ratner, William Harrington, Xuan Feng, Christian Grant, Steve Jacobson, Ariela Noy, Joseph Sparano, Jeannette Lee, Richard Ambinder, Nancy Campbell, Michael Lairmore
Primary Institution: Washington University School of Medicine
Hypothesis
Does combination chemotherapy followed by antiretroviral therapy improve outcomes in adult T-cell leukemia-lymphoma (ATLL)?
Conclusion
EPOCH chemotherapy followed by antiretroviral therapy is effective for ATLL, but viral reactivation during treatment may lead to failures.
Supporting Evidence
- Eleven of twelve evaluable patients had responsive disease, including two complete remissions and nine partial remissions.
- Viral RNA expression increased during chemotherapy, indicating reactivation of the virus.
- Responses were not long-lasting, with relapses occurring shortly after treatment completion.
Takeaway
This study looked at a new treatment for a type of blood cancer caused by a virus, and found that while the treatment worked for some, the virus came back during treatment, making it harder to cure.
Methodology
Nineteen patients received EPOCH chemotherapy followed by antiviral therapy, with responses evaluated based on clinical measurements and viral RNA levels.
Potential Biases
Potential bias due to the small number of patients and the nature of the treatment regimen.
Limitations
The study had a small sample size and a high number of non-evaluable patients due to treatment intensity.
Participant Demographics
Patients were adults with CD4+ HTLV-1+ acute or lymphoma ATLL, enrolled at five medical centers in the U.S.
Statistical Information
P-Value
p<0.05
Confidence Interval
95% confidence intervals from 60% to 99% for evaluable patients and 36% to 77% for all patients.
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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