Treatment strategy for indolent adult T-cell leukemia-lymphoma

Adult T-cell leukemia-lymphoma (ATL), a distinct peripheral T-lymphocytic malignancy associated with human T-lymphotropic virus type-1, can be classified into four subtypes based on clinical manifestations: acute, lymphoma, chronic, and smoldering types. The smoldering and chronic types without poor prognostic factors are classified as indolent ATL. Watchful waiting until disease progression and skin-directed therapy have been recommended as standard treatment strategies, and combination therapy with interferon-alpha and the antiviral drug zidovudine may be used in some cases. High-risk cases for prognosis, identified based on prognostic scores such as Indolent ATL-Prognostic index (iATL-PI) and various biomarkers, should be carefully monitored. Furthermore, early intervention methods must be developed and validated for these cases.