High CADM1 expression in ATLL cells may be associated with transcriptional abnormalities due to the accumulation of genetic or epigenetic alterations; alternatively, CADM1 may interact directly with the PDZ domain of T-lymphoma invasion and metastasis 1 (Tiam1), promoting lamellipodia formation and activating the Rac-regulated actin cytoskeleton, potentially leading to leukemic cell metastasis in ATLL patients (Nakahata and Morishita, 2012). Here, CADM1 is linked to adult T-cell leukemia/lymphoma.