Nikhil Mukhi
SUNY Downstate Medical Center, USA
Title: Adult T-cell leukemia/lymphoma (ATLL): Where we are in 2015
Biography
Biography: Nikhil Mukhi
Abstract
ATLL is an aggressive peripheral T-cell lymphoma (PTCL) associated with clonal proviral DNA integration of human T-cell lymphotropic virus type 1 (HTLV1) with T-lymphocyte. Despite enormous advances in our understanding and treatments of aggressive lymphomas, the progress in ATLL has lagged behind. The acute and lymphomatous types have a poor prognosis with median survival of 6-13 months. Molecular and genetic characterization of this malignancy has been limited due to their rarity and often non-specific morphologic and immunophenotypic features. Currently gene expression profiling and gene sequencing studies are underway for better characterization of genetic abnormalities in this disease. Traditional chemotherapy agents are not very effective in this disease and recently the role of epigenetic dysregulation has been recognized in this disease, which may explain its sensitivity to histone deacetylase (HDAC) inhibitors. In the last 6 years, 4 new drugs have been approved by FDA for patients with relapsed/refractory PTCL: Pralatrexate and 3 HDAC inhibitors (romidepsin, belinostat & vorinostat). Multiple trials are currently underway to explore the integration of these agents in first line setting with standard chemotherapy. These recent advances are changing how we view this disease and hopefully have prepared us to change the future of this disease.