Clinical Features of Adult T-cell Leukemia/Lymphoma (ATL)



The clinical features of adult T-cell leukemia-lymphoma (ATL) vary among patients. The involvement of extranodal lesions is one reason for the heterogeneity of the clinical manifestation of ATL. ATL cells are often found in not only lymph nodes but also extranodal sites such as the peripheral blood, skin, lung, liver, spleen, gastrointestinal tract, bone, and central nervous system, among others. The clinical condition of ATL patients becomes more difficult to manage because of complications such as opportunistic infections and hypercalcemia. For the diagnosis of ATL, confirmation of peripheral T-cell lymphoma and serum anti-human T-cell leukemia virus type I (HTLV-1) antibody is required. Southern blot hybridization analysis is useful for detecting the monoclonal proliferation of HTLV-1-infected cells. After diagnosis of ATL, evaluation of the clinical subtype is required to determine the treatment strategy. ATL patients are classified into four clinical subtypes: smoldering, chronic, acute, and lymphoma. The acute and lymphoma types of ATL are usually called aggressive ATL, and smoldering and chronic types of ATL are called indolent ATL. Several poor prognostic factors have been identified for the chronic type, and chronic ATL patients with poor prognostic factors are classified as having aggressive ATL.


Diagnosis of ATL Clinical subtypes Opportunistic infections Hypercalcemia Extranodal lesions 


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© Springer Japan KK 2017

Authors and Affiliations

  1. 1.Department of HematologyNagasaki University HospitalNagasakiJapan

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