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Immunotherapeutic potential of varicella vaccine in smoldering and cutaneous adult T-cell leukemia/lymphoma

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There are several subtypes of HTLV-1-induced adult T-cell leukemia/lymphoma (ATLL): acute, lymphoma, chronic, and smoldering. Chronic and smoldering ATLL have a relatively good prognosis, even without treatment. However, these types can evolve to acute type ATLL, which has a poor prognosis. Previously we experienced some ATLL patients with improving skin involvements after suffering from herpes zoster and we reported that varicella-zoster virus could be capable of activating the immune system by the manifestation of active inflammation. We postulated that varicella vaccine could be a novel immunotherapeutic agent against ATLL. According to the original protocol, patients received a biweekly administration of varicella vaccine. In this retrospective study, 33 patients were recruited in our institute between March 2002 and December 2010. All patients with a previously untreated and histology proven ATLL were eligible for the purpose of the study. Complete response lasting for six months or more was seen in 6 (18%), partial response in 2 (6%), and no response in 7 (21%) patients, with a median follow-up duration of 27 months (range, 6-99 months). The median overall survival was 24 months and this was significantly longer compared to previously reported f indings (16 months). No serious adverse events were observed. In conclusion, smoldering ATLL with the skin lesions and cutaneous ATLL are promising candidates for this varicella vaccine immunotherapy.

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Correspondence to M Amano.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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Keywords

  • Lymphoma
  • Partial Response
  • Skin Lesion
  • Promising Candidate
  • Herpes Zoster