成人T细胞白血病/淋巴瘤（ATLL）表现出侵略性的临床特征，改善其预后是一个巨大的挑战。一个由无症状人类T细胞白血病病毒1型携带者到侵袭型ATLL的疾病进展模型已经被提出，慢性或良性慢性型的ATLL被定位于中点。即使是最良性的慢性型也有不到60%的4年总生存率。虽然对于慢性ATLL患者来说保守观察是普遍的，但及早治疗也在血液学家中得到了讨论。慢型ATLL曾被称为T细胞来源慢性淋巴细胞白血病（CLL）。与慢性ATLL不同，几种分子靶向药物在初始治疗中已经极大地改善了CLL的预后。近期关于CLL的研究揭示了类似的疾病进展模型，包括前恶性的单克隆B细胞淋巴细胞增生（MBL）。特别是高计数的MBL个体有增加淋巴瘤风险。考虑到慢型ATLL的不满意的长期预后，需要进一步制定治疗策略，包括精准医疗。版权所有 © 2023 Elsevier Ltd.发布。

Adult T-cell leukemia/lymphoma (ATLL) has aggressive clinical behaviors, and improving its prognosis is a great challenge. A disease progression model from asymptomatic human T-cell leukemia virus type 1 carrier to aggressive-type ATLL has been proposed, and indolent ATLL comprising a smoldering or favorable chronic type is located at the midpoint. Even the most favorable smoldering type has a 4-year overall survival rate of <60%. Although watchful waiting is pervasive in patients with indolent ATLL, early therapeutic intervention is discussed among hematologists. Indolent ATLL was once termed T-cell-derived chronic lymphocytic leukemia (CLL). Unlike indolent ATLL, several molecular-targeted agents at the initial treatment have dramatically improved CLL prognosis. Recent studies on CLL have revealed a similar progression model involving premalignant monoclonal B-cell lymphocytosis (MBL). In particular, individuals with high-count MBL have an increased lymphoma risk. Considering the unsatisfactory long-term prognosis of indolent ATLL, further treatment strategies, including precision medicine, are warranted.Copyright © 2023. Published by Elsevier Ltd.