NCCN Guidelines Insights: T-Cell Lymphomas, Version 1.2021

Horwitz, Steven M.; Ansell, Stephen M.; Ai, Weiyun Z.; Barnes, Jeffrey A.; Barta, Stefan K.; Clemens, Mark W.; Doğan, Ahmet; Goodman, Aaron M.; Goyal, Gaurav; Guitart, Joan; Halwani, Ahmad; Haverkos, Bradley M.; Hoppe, Richard T.; Jacobsen, Eric; Jagadeesh, Deepa; Jones, Allison; Kim, Youn H.; Mehta‐Shah, Neha; Olsen, Elise A.; Pro, Barbara; Rajguru, Saurabh; Rozati, Sima; Said, Jonathan; Shaver, Aaron C.; Shustov, Andrei R.; Sokol, Lubomir; Torka, Pallawi; Torres‐Cabala, Carlos A.; Wilcox, Ryan A.; William, Basem M.; Zain, Jasmine; Dwyer, Mary A.; Sundar, Hema

doi:10.6004/jnccn.2020.0053

Cited by 47 publications

(38 citation statements)

References 44 publications

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“…Data is also emerging that distinct molecular signatures can define prognostic groups and may point towards more rational treatment strategies. In this manuscript we will attempt to highlight these findings and where appropriate indicate prognostic and therapeutic opportunities particularly specific targeted modalities that appear promising and are quickly being incorporated in the treatment paradigms of PTCL 3 …”

Section: Introductionmentioning

confidence: 99%

Aggressive T‐cell lymphomas: 2021 Updates on diagnosis, risk stratification and management

Zain

Hanona²

2021

American J Hematol

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Introduction: Aggressive T-cell lymphomas continue to have a poor prognosis. There are over 27 different subtypes of peripheral T-cell lymphoma (PTCL), and we are now beginning to understand the differences between the various subtypes beyond histologic variations. Molecular Pathogenesis of Various Subtypes of PTCL: Gene expression profiling (GEP) can help in diagnosis and prognostication of various subtypes including PTCLnos and anaplastic large cell lymphoma (ALCL). In addition, mutational analysis is now being incorporated in clinical trials of novel agents to evaluate various biomarkers of response to allow better therapeutic choices for patients. Targeted Therapies: There are many targeted agents currently in various stages of clinical trials for PTCL that take advantage of the differential expression of specific proteins or receptors in PTCL tumors. This includes the CD30 directed antibody drug conjugate brentuximab vedotin. Other notable targets are CD25, CCR4, inhibition of PI3kinasem TOR and JAK/STAT pathways. The ALK inhibitors are promising for ALK expressing tumors. Immunotherapies: Allogeneic stem cell transplant continues to be the curative therapy for most aggressive subtypes of PTCL. The use of checkpoint inhibitors in the treatment of PTCL is still controversial. The most promising results have been seen in cases of extranodal natural killer cell/T-cell (ENK/T) lymphomas and cutaneous T-cell lymphomas (CTCL). Bispecific antibody based treatments as well as CAR-T cell based therapies are in clinical trials.

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Section: Introductionmentioning

confidence: 99%

Aggressive T‐cell lymphomas: 2021 Updates on diagnosis, risk stratification and management

Zain

Hanona²

2021

American J Hematol

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“…Comprehensive Cancer Network (NCCN) guidelines for T-cell lymphoma (2018 version), clinical trials and multiagent chemotherapy are recommended as the treatments for TCL patients, except for those with ALK-positive ALCL and NT/T-cell lymphoma [3]. Most patients are treated with CHOP/CHOP-like chemotherapy regimens.…”

Section: Ivyspring International Publishermentioning

confidence: 99%

Programmed Cell Death Protein 1/Programmed Cell Death Ligand-1 Axis activates Intracellular ERK Signaling in Tumor Cells to Mediate Poor Prognosis in T-cell Lymphoma

Fei

Liu

et al. 2021

J. Cancer

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Purpose: To investigate the prognostic significance of programmed cell death ligand-1 (PD-L1) and phosphorylated ERK (p-ERK) and their interactions in T-cell lymphoma (TCL). Methods: The mRNA levels of PD-L1 and ERK in TCL samples were analyzed. Formalin-fixed paraffin-embedded tissues from 69 TCL patients were collected to detect the expression of PD-L1 and p-ERK by multiplexed immunofluorescence staining. The total PD-L1 and p-ERK was measured by western blotting, and membrane PD-L1 was determined using flow cytometry. Results: PD-L1 and ERK mRNA levels were significantly upregulated in TCL. The expression rates of PD-L1 and p-ERK were 52.2% and 27.5%, respectively. PD-L1 expression correlated with stage (R=0.304, P=0.011) and IPI score (R=0.313, P=0.009), and p-ERK expression correlated with stage (R=0.330, P=0.006) and IPI score (R=0.376, P=0.002). PD-L1 expression positively correlated with p-ERK expression (R=0.355, P=0.003). Patients with co-expression of PD-L1 and p-ERK had the worst overall survival (P=0.007). In three TCL cell lines with PD-L1 expression, we demonstrated that the expression of p-ERK was upregulated after stimulation with PD-1, suggesting that ERK signaling was activated. Conclusions: The PD-1/PD-L1 axis activates intracellular ERK signaling in tumor cells and that PD-L1, p-ERK or their combination are potential biomarkers for predicting the prognosis in TCL patients.

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“…Patients in the two groups were given cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) or CHOP-like chemotherapy as the rst line. [7][8][9] Patients with relapse and refractory were given iceifosfamide, carboplatin, etoposide (ICE), gemcitabine, dexamethasone, cisplatin (GDP) and other second-line regimens as the guideline recommended and some high-risk patients were given autologous hematopoietic stem cell transplantation or maintenance treatment with lenalidomide or chidamide. 10…”

Section: Chemotherapymentioning

confidence: 99%

Clinical Features and Long-term Outcomes of Lymphoma Patients Initially Presenting as Fever With Unknown Origin

Wulipan

et al. 2021

Preprint

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BackgroundLymphoma is found to be the main source of non-infectious fever of unknown origin (FUO). However, there is a lack of clinical features and outcomes in lymphoma patients initially presenting as FUO.MethodsFrom January 1, 2013 to December 31, 2019, our center enrolled 185 patients who initially presented as FUO then confirmed to be lymphoma in Huadong Hospital of Fudan University. During the same study period, 332 lymphoma patients without FUO received treatment in our center. After the exclusion, 509 patients were included in the retrospectively study. The differences in clinical manifestations, laboratory examinations, overall response rates and survival rates between the FUO and non-FUO groups were analyzed. The clinical endpoints were overall survival (OS) and progress-free survival (PFS).ResultsIn the non-FUO group (329 in total), Hodgkin’s lymphoma (HL) was 17 (5.2%), B cell non-Hodgkin’s lymphoma (B-NHL) was 276 (83.9%), T cell non-Hodgkin’s lymphoma (T-NHL) was 32 (9.7%) and NK/T cell lymphoma (NK/T-CL) was 4 (1.2%). In the FUO group (180 in total), B-NHL was 88 (48.9%), T-NHL was 60 (33.3%), NK/T-CL was 24 (13.3%) and HL was 8 (4.4%). During the hospitalization, the maximum body temperature of the FUO group diagnosed with B-NHL, T-NHL and NK/T-CL was statistically higher than that of the non-FUO group (all P<0.05). Concerning the overall response rates, there was no difference between the FUO and non-FUO groups, whatever the pathological subtype was. The differences in OS between the FUO and non-FUO groups were significant for HL (P=0.006), B-NHL (P=0.007) and T-NHL (P=0.013). No difference in overall survival was observed in the two groups for the subtype of NK/T-CL (P=0.141). In terms of PFS, there was no significant difference between FUO and non-FUO groups for any subtype (all P>0.05).ConclusionWe found that the major subtypes of lymphoma initially presenting as FUO were B-NHL and T-NHL. The main diagnostic biopsy sites were subcutaneous lymphnodes, bone marrow and spleen for lymphoma patients with FUO. Patients with FUO suffered from a higher risk of all-cause death in the long term.

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NCCN Guidelines Insights: T-Cell Lymphomas, Version 1.2021

Cited by 47 publications

References 44 publications

Aggressive T‐cell lymphomas: 2021 Updates on diagnosis, risk stratification and management

Aggressive T‐cell lymphomas: 2021 Updates on diagnosis, risk stratification and management

Programmed Cell Death Protein 1/Programmed Cell Death Ligand-1 Axis activates Intracellular ERK Signaling in Tumor Cells to Mediate Poor Prognosis in T-cell Lymphoma

Clinical Features and Long-term Outcomes of Lymphoma Patients Initially Presenting as Fever With Unknown Origin

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