T-cell gamma/delta hepatosplenic lymphoma - prolonged remission induced by aggressive first line treatment

Procházka, Vít; Papajík, Tomáš; Jarošová, Marie; Pikalova, Zuzana; Indrák, Karel; Tichý, M; Kučerová, Ladislava; Fakan, F; Bílý, Milan; Starostka, David

doi:10.5507/bp.2005.040

Cited by 6 publications

(2 citation statements)

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“…38,39 Several authors suggest superior outcome with the addition of HDT-SCT, and a number of reports include cases treated successfully with autologous and allogeneic SCT. 11,12,25,33,[40][41][42][43][44][45][46][47] There are only 2 reports of larger single-center experiences in the literature thus far. The first was published by Belhadj and colleagues in 2003 and includes data from 21 patients with HSTCL diagnosed between 1981 and 2001.…”

Section: Discussionmentioning

confidence: 99%

“…25,33 Anecdotal activity of several other chemotherapy regimens has been reported in form of case reports. [34][35][36][37][38][39] Several authors have published experiences with high-dose therapy (HDT) autologous or allogeneic stem cell transplantation (SCT), 11,12,25,33,[40][41][42][43][44][45][46] and a 2007 collection of published case reports of HSTCL treated with allogeneic stem cell transplantation suggests a better outcome for that approach. 47…”

Section: Introductionmentioning

confidence: 99%

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Intensive Induction Chemotherapy Followed by Early High-Dose Therapy and Hematopoietic Stem Cell Transplantation Results in Improved Outcome for Patients with Hepatosplenic T-Cell Lymphoma: A Single Institution Experience.

Voss

Zelenetz

Papadopoulos

et al. 2007

Blood

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Introduction: Hepatosplenic T-cell lymphoma (HSTCL) is a rare form of non-Hodgkin lymphoma with unique features including presentation primarily in young men, lymphomatous infiltration of the liver and spleen, frequent bone marrow involvement, B symptoms, infrequent lymphadenopathy and poor prognosis. First described by Farcet and Gaulard1, there are two larger published series in whom only 6/66 of patients (pts) were alive at the time of the reports. 2,3 4/6 surviving pts in these reports had undergone high dose therapy and autologous or allogeneic stem cell transplantation (HDT-SCT). There are no prospective studies of treatment of HSTCL but a recent review of published case reports of HSTCL treated with allogeneic SCT suggests a better outcome for that approach.4 Methods: We reviewed our T-cell lymphoma and bone marrow transplantation databases to examine our results in pts with HSTCL. We identified 9 consecutive pts with this diagnosis. This report summarizes our single center experience. Results: All pts were male with a median age of 37y (12–59). All pts had stage IV disease with hepatomegaly and/or splenomegaly. 5/9 had documented bone marrow involvement, 7 had elevated LDH, and all 9 had B symptoms. Thrombocytopenia was present at diagnosis in 5 pts, anemia in 4 pts, and leukopenia in 4 pts. Transaminases and/or alkaline phosphatase were elevated in 6 pts. 4/9 had previous autoimmune disease: 2 with ulcerative colitis and 2 with rheumatoid arthritis. Responses to induction regimens were: CHOP (PR-2, POD-1) ICE/IVAC (CR-2, PR-2), pentostatin/2-CDA (POD-2). 2/4 pt achieved a CR to ICE as second line therapy. 8/9 pts achieved at least a PR and proceeded to HDT-SCT. 6 pts received an allogeneic SCT (one after relapse from autologous SCT), and 3 pts an autologous SCT. At the time of this report, 4/9 patients are alive in remission, 20–158 mos from diagnosis; the 4 surviving patients all underwent HDT/SCT. Following autologous-SCT 2/3 pts relapsed at 5 and 35 mos. Following Allogeneic-SCT 2/6 pts relapsed at 3 and 6 mos, 1 of whom was effectively treated with donor lymphocytes and remains in remission at 20 mos. 2/6 pts undergoing allo-SCT died of treatment related toxicities without documented recurrent disease. Complete information to determine the age-adjusted international prognostic index (aaIPI) was available for 8/9 pts; the aaIPI appeared to correlate with outcome: 4/5 pts with an aaIPI of low intermediate to high intermediate risk (1–2 factors) were alive compared to 0/3 aaIPI high risk disease (3 factors). The prognostic index for PTCL (PIT) consisting of age, performance status, LDH, and bone marrow involvement was also assessed. All 8 pts had at least one risk factor; 4/6 pts with a PIT of 1–2 were alive vs 0/2 pts for PIT of ≥3. Four pts received ICE or IVAC as their initial therapy and 3/4 were alive compared to only 1/5 for those who received other initial regimens. Conclusions: In this single institution experience, use of non-CHOP induction chemotherapy regimens such as ICE or IVAC and early use of HDT-SCT consolidation appear to improve the outcome for pts with HSTCL compared to reported results with CHOP or CHOP-like regimens.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Intensive Induction Chemotherapy Followed by Early High-Dose Therapy and Hematopoietic Stem Cell Transplantation Results in Improved Outcome for Patients with Hepatosplenic T-Cell Lymphoma: A Single Institution Experience.

Voss

Zelenetz

Papadopoulos

et al. 2007

Blood

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Intensive Induction Chemotherapy Followed by Early High-Dose Therapy and Hematopoietic Stem Cell Transplantation Results in Improved Outcome for Patients with Hepatosplenic T-Cell Lymphoma: A Single Institution Experience

Voss

Lunning

Maragulia

et al. 2013

Clinical Lymphoma Myeloma and Leukemia

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Hepatosplenic T-cell lymphoma is a rare form of non-Hodgkin lymphoma, which carries a poor prognosis. We report our single-institution experience in the management of hepatosplenic T-cell lymphoma (HSTCL)- in 14 patients (pts) among whom 7 who remain alive (50%) and in remission at a median follow-up of 66 months. More frequent long-term survival was seen in those treated with a non-CHOP (cyclophosphamide/doxorubicin/vincristine/prednisone) induction and consolidative stem cell transplant (SCT). Introduction Hepatosplenic T-cell lymphoma is a rare form of extranodal non-Hodgkin lymphoma, first recognized as a distinct entity in the Revised European-American Lymphoma classification. Typical presentation includes lymphomatous infiltration of spleen and liver, and peripheral lymphadenopathy is rarely seen. The prognosis is almost uniformly poor, and there are no prospective studies of treatment of HSTCL. Patients and Methods For this report, we conducted a retrospective review of all pts who underwent treatment for HSTCL at our institution. Individual chart review was performed to report clinical presentation, management, and outcome. Results We identified 14 pts with HSTCL managed at our center, 7 of which remain alive with median follow-up of 65.6 months. Six of 7 received alternative induction chemotherapy regimens such as ICE (ifosfamide, carboplatin, etoposide) or IVAC (ifosfamide, etoposide, high-dose cytarabine) as opposed to CHOP and all surviving pts had proceeded to undergo either autologous or allogeneic SCT. Conclusion Our results suggest that use of non-CHOP induction regimen and early use of high dose therapy and SCT consolidation may translate to improved survival for pts with HSTCL.

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Hepatosplenic γδ T-cell Lymphoma: An Overview

Visnyei

Grossbard

Shapira

2013

Clinical Lymphoma Myeloma and Leukemia

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T-cell gamma/delta hepatosplenic lymphoma - prolonged remission induced by aggressive first line treatment

Cited by 6 publications

References 6 publications

Intensive Induction Chemotherapy Followed by Early High-Dose Therapy and Hematopoietic Stem Cell Transplantation Results in Improved Outcome for Patients with Hepatosplenic T-Cell Lymphoma: A Single Institution Experience.

Intensive Induction Chemotherapy Followed by Early High-Dose Therapy and Hematopoietic Stem Cell Transplantation Results in Improved Outcome for Patients with Hepatosplenic T-Cell Lymphoma: A Single Institution Experience.

Intensive Induction Chemotherapy Followed by Early High-Dose Therapy and Hematopoietic Stem Cell Transplantation Results in Improved Outcome for Patients with Hepatosplenic T-Cell Lymphoma: A Single Institution Experience

Hepatosplenic γδ T-cell Lymphoma: An Overview

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