Reprogramming cellular gene transcription sustains HTLV-1 viral persistence that ultimately leads to the development of adult T-cell leukemia/lymphoma (ATLL). We hypothesized that besides these quantitative transcriptional effects. HTLV-1 quantitatively modifies the pattern of cellular gene expression. Exon expression analysis shows that patients’ untransformed and malignant HTLV-1+ CD4+ T-cells exhibit multiple alternate exon usage (AEU) events. These affect either transcriptionally modified or unmodified genes, culminate in ATLL, and unveil new functional pathways involved in cancer and cell cycle. A total of 486 exon modifications occurred in untransformed infected CD4+ cells were detected in ATLL arguing for a role of AEUs in HTLV-1 leukemogenesis. Unsupervised hierarchical clustering of array data permitted to isolate exon expression patters of 3977 exons that discriminate uninfected, infected, and transformed CD4+ T-cells. Exposing cells to splicing inhibitors revealed that Sudemycin E reduces cell viability of HTLV-1 transformed cells without affecting primary control CD4+ cells and HTLV-1 negative cell lines, suggesting that the huge excess of AEU might provides news targets for treating ATLL. Taken together, these data reveal that HTLV-1 significantly modifies the structure of cellular transcripts and unmask new putative leukemogenic pathways and possible therapeutic targets
