A Study for Aggressive Adult T-cell Leukemia-lymphoma (ATLL)

Inclusion Criteria: 1. Diagnosis of ATL was made based on seropositivity for HTLV-I by either enzyme-linked immunosorbent assay or particle agglutination assay, and histologically- and/or cytologically-proven peripheral T-cell malignancy 2. Aggressive ATL, i.e., acute-, lymphoma- or unfavorable chronic-type ATL 3. Aged 15-69 years 4. No prior chemotherapy or radiotherapy 5. Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-3 or 4 as a result of hypercalcemia 6. Preserved organ (bone marrow, liver, kidney, heart and lung) functions 7. All patients were required to provide written informed consent Exclusion Criteria: 1. Diabetes mellitus necessitating treatment with insulin 2. Active systemic infection 3. Cardiac disorders expected to become worse as a result of the DOX-containing regimen 4. Acute hepatitis, chronic hepatitis or liver cirrhosis 5. Positive for HBs Ag or anti-HCV Ab 6. Active concurrent malignancy 7. Other serious medical or psychiatric conditions 8. Pregnancy or breast feeding 9. Central nervous system involvement by ATL cells