Intensive Induction Therapy Compared With CHOP for Hepatosplenic T-cell Lymphoma

Klebaner, Daniella; Koura, Divya; Tzachanis, Dimitrios; Ball, Edward D.; Horwitz, Steven M.; Goodman, Aaron M.

doi:10.1016/j.clml.2019.10.007

Cited by 4 publications

(8 citation statements)

References 67 publications

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“…[44][45][46] A more recent individual-level meta-analysis (which represents the largest aggregation of all published studies and case reports to date: 166 patients with a diagnosis of HSTCL) compared the response rates and overall survival outcomes of 84 patients with HSTCL treated with CHOP or CHOP-like regimens (n550) or non-CHOP-based regimens, specifically those containing cytarabine, platinum, and etoposide (n534). 35 Non-CHOP-based regimens were associated with an overall response rate of 82% compared with 52% for CHOP or CHOP-like regimens (P5.006), and median survival was 37 and 18 months, respectively (P5.00014). Use of non-CHOP-based regimens was a significant predictor of higher response rate (P5.049) and improved survival (P5.026).…”

Section: Treatmentmentioning

confidence: 95%

“…More intensive non-CHOP-based chemotherapy regimens, such as ICE (ifosfamide/carboplatin/etoposide) or IVAC (ifosfamide/ etoposide/cytarabine) have been associated with potentially improved outcomes. [32][33][34][35] Purine analogs (pentostatin or cladribine) either as monotherapy or in combination with alemtuzumab have also demonstrated modest activity. [36][37][38][39][40][41] Few studies have reported improved survival outcomes with autologous or allogeneic HCT as consolidation therapy for patients with disease in first or second remission.…”

Section: Treatmentmentioning

confidence: 99%

“…CHOP is not considered adequate therapy. 35 The NCCN Guidelines for T-Cell Lymphomas have included ICE as the preferred regimen for induction therapy because it is used in most NCCN Member Institutions (see HSTCL-A, page 1465). Other intensive induction therapy regimens, such as IVAC and hyper-CVAD (cyclophosphamide/ vincristine/doxorubicin/dexamethasone) alternating with high-dose methotrexate and cytarabine, may also be appropriate.…”

Section: Nccn Recommendationsmentioning

confidence: 99%

“…Other intensive induction therapy regimens, such as IVAC and hyper-CVAD (cyclophosphamide/ vincristine/doxorubicin/dexamethasone) alternating with high-dose methotrexate and cytarabine, may also be appropriate. 34,35 Alemtuzumab 1 pentostatin, CHOEP (cyclophosphamide/doxorubicin/vincristine/etoposide/ prednisone), dose-adjusted EPOCH (etoposide/prednisone/ vincristine/cyclophosphamide/doxorubicin), and DHAP or DHAX (dexamethasone/cytarabine) 1 cisplatin or oxaliplatin are included as alternative options.…”

Section: Nccn Recommendationsmentioning

confidence: 99%

“…Consolidation therapy with allogeneic HCT is recommended for eligible patients experiencing complete or partial response after initial induction or second-line therapy (see HSTCL-3, page 1464). 35,40,43 Consolidation therapy with autologous HCT can be considered if a suitable donor is not available or in patients who are ineligible for allogeneic HCT. 34 Patients with disease not responding to primary treatment or those with progressive disease should be treated with alternate induction therapy regimens before receiving treatment for relapsed/refractory disease.…”

Section: Nccn Recommendationsmentioning

confidence: 99%

See 4 more Smart Citations

NCCN Guidelines Insights: T-Cell Lymphomas, Version 1.2021

Horwitz

Ansell²,

et al. 2020

Journal of the National Comprehensive Cancer Network

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Hepatosplenic T-cell lymphoma (HSTCL) is a rare subtype of T-cell lymphoma associated with an aggressive clinical course and a worse prognosis. HSTCL develops in the setting of chronic immune suppression or immune dysregulation in up to 20% of cases and is most often characterized by spleen, liver, and bone marrow involvement. Diagnosis and management of HSTCL pose significant challenges given the rarity of the disease along with the absence of lymphadenopathy and poor outcome with conventional chemotherapy regimens. These Guidelines Insights focus on the diagnosis and treatment of HSTCL as outlined in the NCCN Guidelines for T-Cell Lymphomas.

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Section: Treatmentmentioning

confidence: 95%

Section: Treatmentmentioning

confidence: 99%

Section: Nccn Recommendationsmentioning

confidence: 99%

Section: Nccn Recommendationsmentioning

confidence: 99%

Section: Nccn Recommendationsmentioning

confidence: 99%

See 3 more Smart Citations

NCCN Guidelines Insights: T-Cell Lymphomas, Version 1.2021

Horwitz

Ansell²,

et al. 2020

Journal of the National Comprehensive Cancer Network

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Hepatosplenic T-cell lymphoma: treatment challenges

Bron

Leval

Michiels

et al. 2021

Current Opinion in Oncology

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Purpose of reviewHepatosplenic lymphoma (HSTCL) is a rare T-cell malignancy occurring in young males, associated with immune deficiency in 20% of the cases which, despite aggressive treatments, has a poor survival. Specific recommendations for first-line treatment remain debatable. Recent findingsPublished data covering case reports or series of HSTCL concur that allogeneic stem cell transplant should be proposed as a consolidation after response to chemotherapy in all patients eligible for transplant. In the light of two recent clinical examples, we also confirm that specific chemotherapy and a first-line consolidation with allogeneic transplantation when a donor is available to represent a treatment of choice these rare and distinctive lymphomas. Recent molecular studies are summarized in this review and suggest potential targets for new therapeutic strategies.

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Current and upcoming treatment approaches to uncommon subtypes of PTCL (EATL, MEITL, SPTCL, and HSTCL)

Marchi,

Craig,

Kalac

2024

Blood

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Rare subtypes of peripheral T-cell lymphoma (PTCL) including enteropathy-associated T-cell lymphoma (EATL), monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL), subcutaneous panniculitis-like T-cell lymphoma (SPTCL) and hepatosplenic T-cell lymphoma (HSTCL) are underrepresented in most registry and clinical studies. Most of the literature is obtained from small case series, single-institution retrospective studies and subgroup analyses of the largest studies with few recent and ongoing exceptions. While the pathogenesis and biology of these entities have yet to be fully elucidated, global efforts by the scientific community have started to shed some light on the most frequently deregulated pathways. In this review, we highlight the most pertinent clinical and pathologic features of rare subtypes of PTCL including EATL/MEITL, SPTCL and HSTCL. We also summarize the results of recent developments identifying potential targets for novel therapeutic strategies based on molecular studies. Finally, we highlight the underrepresentation of these rare subtypes in most clinical trials, making evidence-based therapeutic decisions extremely challenging.

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Intensive Induction Therapy Compared With CHOP for Hepatosplenic T-cell Lymphoma

Cited by 4 publications

References 67 publications

NCCN Guidelines Insights: T-Cell Lymphomas, Version 1.2021

NCCN Guidelines Insights: T-Cell Lymphomas, Version 1.2021

Hepatosplenic T-cell lymphoma: treatment challenges

Current and upcoming treatment approaches to uncommon subtypes of PTCL (EATL, MEITL, SPTCL, and HSTCL)

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