Tax is the main oncoprotein in HTLV-1, therefore its association with EVs may have potential effects in perpetuating Tax-mediated pathogenesis, including the induction of NF-κB in recipient cells which may promote the development of ATLL (Azimi et al., 1998; de la Fuente et al., 2000; Azran et al., 2004). Here, NFKB1 is linked to adult T-cell leukemia/lymphoma.