Sandbox: ATL: Difference between revisions
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* Skin directed therapies for the management of localized cutaneous lesions among such patients may include: | * Skin directed therapies for the management of localized cutaneous lesions among such patients may include: | ||
:* Topical corticosteroids | :* Topical corticosteroids | ||
:* Topical chemotherapy (mechlorethamine | :* Topical chemotherapy (mechlorethamine) | ||
:* Local radiation (8–36 Gy) | :* Local radiation (8–36 Gy) | ||
:* Topical retinoids (bexarotene, tazarotene) | :* Topical retinoids (bexarotene, tazarotene) |
Revision as of 18:50, 25 January 2016
- The optimal therapy for adult T-cell leukemia depends on the clinical variant of the disease.
- Chronic and smoldering adult T-cell leukemia patients are usually managed by either observation, skin directed therapies, or a combination of idovudine and interferon therapy.
- Acute adult T-cell leukemia patients are usually managed by either chemotherapy, supportive care, allogeneic stem cell transplant, or a combination of zidovudine and interferon therapy.
- Adult T-cell lymphoma patients are usually managed by either chemotherapy, supportive care, or allogeneic stem cell transplant.
Chronic/Smoldering Adult T-cell Leukemia Management
- Patients may be managed by observation and close follow-up for any symptomatic deterioration. Follow up tests for such patients may include:
- Complete history and physical examination
- Serum calcium level
- Blood urea nitrogen
- Serum creatinine level
- Serum LDH
- Chest and abdominal CT scan
- Skin directed therapies for the management of localized cutaneous lesions among such patients may include:
- Topical corticosteroids
- Topical chemotherapy (mechlorethamine)
- Local radiation (8–36 Gy)
- Topical retinoids (bexarotene, tazarotene)
- Phototherapy (UVB, NB-UVB for patch/thin plaques; PUVA for thicker plaques)
- Topical imiquimod
- Zidovudine and interferon combination therapy:
- Chronic/smoldering adult T-cell leukemia patients should be evaluated for response after two months of initiating the combination therapy.
- Responders should be continued on zidovudine and interferon therapy.
- While non-responders should be managed by either chemotherapy or supportive care depending on the patients preference.
- Response criteria for adult T-cell leukemia patients includes:
- Absence of lymphadenopathy
- Absence of hepatomegaly and splenomegaly
- Absence of cutaneous lesions
- Absence of malignant on peripheral blood smear
- Absence of malignant on bone marrow biopsy