Treatment and prognosis of mature T-cell and NK-cell lymphoma: an analysis of patients with T-cell lymphoma treated in studies of the German High-Grade Non-Hodgkin Lymphoma Study Group

Schmitz, Norbert; Trümper, Lorenz; Ziepert, Marita; Nickelsen, Maike; Ho, Anthony D.; Metzner, Bernd; Peter, Norma; Loeffler, Markus; Rosenwald, Andreas; Pfreundschuh, Michael

doi:10.1182/blood-2010-02-270785

Cited by 513 publications

(416 citation statements)

References 32 publications

Supporting

Mentioning

375

Contrasting

Unclassified

Order By: Relevance

“…For the seven chemonaive patients, the ORR was 71.4% and the CR was 42.9%. The results were consistent with results previously described in detail using the CHOP regimen [15][16][17][18][19] .…”

Section: Discussionsupporting

confidence: 82%

Pharmacodynamic and pharmacokinetic study of pegylated liposomal doxorubicin combination (CCOP) chemotherapy in patients with peripheral T-cell lymphomas

et al. 2011

View full text Add to dashboard Cite

Aim: To investigate the pharmacodynamic and pharmacokinetic parameters of pegylated liposomal doxorubicin (PLD) combined with cyclophosphamide, vincristine, and prednisolone in patients with peripheral T-cell lymphomas (PTCL). Methods: Seven chemonaive patients and four patients with relapsed peripheral T-cell lymphomas were treated with a CCOP regimen consisting of an intravenous administration of cyclophosphamide (750 mg/m 2 ), vincristine (1.4 mg/m 2 ), and PLD (30 mg/m 2 ) on d 1, as well as an oral administration of prednisolone (60 mg/m 2 ) on d 1-5. This regimen was repeated every 3 weeks for six cycles, and the clinical response and toxicity of the regimen were monitored. In addition, the plasma concentration of PLD at different time points was determined before and after treatment. The pharmacokinetics (PKs) software was used to estimate the pharmacokinetic parameters of PLD. Results: The 11 PTCL patients received 35 treatment cycles. Three of them achieved complete response (CR), two partial response (PR), four stable disease (SD), and two progressive disease (PD). The overall response rate (ORR) was 45.5%, and the CR rate was 27.3%. In the 7 chemonaive patients, three achieved CR, two PR, one SD, and one PD. The ORR was 71.4%, and CR rate was 42.9%. The median follow-up time was 15 months, but 6 out of 11 patients were dead at the time of data analysis. The 1-year overall survival rate was 45.5%, and the median progression-free survival (PFS) rate was 6.5 [95% confidence interval (95% CI) 3.17-19.02] with a survival rate of 11.5 months (95% CI 6.65-16.36). The main toxicity was myelosuppression. Oral mucositis and hand-foot syndrome seldom occurred. The PLD plasma concentration from nine patients ranged from 1.7036 to 9.2207 mg·L -1 after administration of the CCOP regimen (0-168 h). The pharmacokinetic parameters AUC 0-∞ , CL, t 1/2 , and V d were 910.76 mg/L·h, 0.043 L·h -1 ·m -2 , 68.40 h, and 3.56 L/m 2 , respectively. Conclusion: The CCOP regimen was effective and well tolerated in patients with peripheral T-cell lymphomas. The results of the pharmacokinetic parameters showed that PLD had long retention time in blood circulation.

show abstract

Section: Discussionsupporting

confidence: 82%

Pharmacodynamic and pharmacokinetic study of pegylated liposomal doxorubicin combination (CCOP) chemotherapy in patients with peripheral T-cell lymphomas

et al. 2011

View full text Add to dashboard Cite

show abstract

“…However, cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) is not an optimal treatment for these patients with 40% of patients with ALK-positive disease and over 60% of patients with ALK-negative disease failing to be cured using this approach [27]. German investigators have reported an improved failure-free survival when patients receive CHOP plus etoposide [47]. The ACVBP regimen, which includes a high dose consolidation phase after the initial induction, is highly active in diffuse large B-cell lymphoma and has also been utilized in patients with anaplastic large-cell lymphoma [48].…”

Section: Risk-adapted Therapy Of Specific Subtypesmentioning

confidence: 99%

“…The National Comprehensive Cancer Network Guidelines for the treatment of patients recommend a clinical trial as the best initial treatment option [5]. There is some evidence that the combination of CHOP plus etoposide is more effective than CHOP alone [47], and this is the regimen that I favor. Other regimens that have been utilized include CHOP plus alentuzumab [70], CHOP plus denileukin diftitox [71], CHOP plus bortezomib [62], and other intensive regimens, such as ACVBP [73] and Hyper-CVAD [74].…”

Section: Peripheral T-cell Lymphoma Not Otherwise Specifiedmentioning

confidence: 99%

The aggressive peripheral T‐cell lymphomas: 2015

Armitage

2015

American J Hematol

View full text Add to dashboard Cite

Background: T‐cell lymphomas make up approximately 10%–15% of lymphoid malignancies. The frequency of these lymphomas varies geographically, with the highest incidence in parts of Asia.Diagnosis: The diagnosis of aggressive peripheral T‐cell lymphoma (PTCL) is usually made using the World Health Organization classification. The ability of hematopathologists to reproducibly diagnosis aggressive PTCL is lower than that for aggressive B‐cell lymphomas, with a range of 72%–97% for the aggressive PTCLs.Risk Stratification: Patients with aggressive PTCL are staged using the Ann Arbor Classification. Although somewhat controversial, positron emission tomography scans seem to be useful as they are in aggressive B‐cell lymphomas. The most commonly used prognostic index is the International Prognostic Index. The specific subtype of aggressive PTCL is an important risk factor, with the best survival seen in anaplastic large‐cell lymphoma—particularly young patients with the anaplastic lymphoma kinase positive subtype.Risk‐Adapted Therapy: Anaplastic large‐cell lymphoma is the only subgroup to have a good response to a CHOP‐like regimen. Angioimmunoblastic T‐cell lymphoma has a prolonged disease‐free survival in only ∼20% of patients, but younger patients who have an autotransplant in remission seem to do better. PTCL‐not otherwise specified is not one disease. Anthracycline‐containing regimens have disappointing results, and a new approach is needed. Natural killer/T‐cell lymphoma localized to the nose and nasal sinuses seems to be best treated with radiotherapy‐containing regimens. Enteropathy‐associated PTCL and hepatosplenic PTCL are rare disorders with a generally poor response to therapy, although selected patients with enteropathy‐associated PTCL seem to benefit from intensive therapy. Am. J. Hematol. 90:666–673, 2015. © 2015 Wiley Periodicals, Inc.

show abstract

“…The German High Grade Non-Hodgkin's Lymphoma Study Group (DSHNHL) similarly reported on more than 200 patients with T-NHL enrolled onto prospective trials; 3-year event-free survival was best for ALK-positive ALCL (75%) and suboptimal for all other histologies. 2 Attempts to improve outcomes have included autologous or allogeneic hematopoietic…”

Section: Introductionmentioning

confidence: 99%

Hematopoietic Cell Transplantation for Systemic Mature T-Cell Non-Hodgkin Lymphoma

Smith

Burns

Besien

et al. 2013

JCO

211

161

View full text Add to dashboard Cite

A B S T R A C T PurposeTo analyze outcomes of hematopoietic cell transplantation (HCT) in T-cell non-Hodgkin lymphoma. Patients and MethodsOutcomes of 241 patients (112 anaplastic large-cell lymphoma, 102 peripheral T-cell lymphoma not otherwise specified, 27 angioimmunoblastic T-cell lymphoma) undergoing autologous HCT (autoHCT; n ϭ 115; median age, 43 years) or allogeneic HCT (alloHCT; n ϭ 126; median age, 38 years) were analyzed. Primary outcomes were nonrelapse mortality (NRM), relapse/progression, progression-free survival (PFS), and overall survival (OS). Patient, disease, and HCT-related variables were analyzed in multivariate Cox proportional hazard models to determine association with outcomes. ResultsAutoHCT recipients were more likely in first complete remission (CR1; 35% v 14%; P ϭ .001) and with chemotherapy-sensitive disease (86% v 60%; P Ͻ .001), anaplastic large-cell histology (53% v 40%; P ϭ .04), and two or fewer lines of prior therapy (65% v 44%; P Ͻ .001) compared with alloHCT recipients. Three-year PFS and OS of autoHCT recipients beyond CR1 were 42% and 53%, respectively. Among alloHCT recipients who received transplantations beyond CR1, 31% remained progression-free at 3 years, despite being more heavily pretreated and with more refractory disease. NRM was 3.5-fold higher (95% CI, 1.80 to 6.99; P Ͻ .001) for alloHCT. In multivariate analysis, chemotherapy sensitivity (hazard ratio [HR], 1.8; 95% CI, 1.16 to 2.87) and two or fewer lines of pretransplantation therapy (HR, 5.02; 95% CI, 2.15 to 11.72) were prognostic of survival. ConclusionThese data describe the roles of autoHCT and alloHCT in T-cell non-Hodgkin lymphoma and suggest greater effectiveness earlier in the disease course, and limited utility in multiply relapsed disease. Notably, autoHCT at relapse may be a potential option for select patients, particularly those with anaplastic large-cell lymphoma histology.

show abstract

Treatment and prognosis of mature T-cell and NK-cell lymphoma: an analysis of patients with T-cell lymphoma treated in studies of the German High-Grade Non-Hodgkin Lymphoma Study Group

Cited by 513 publications

References 32 publications

Pharmacodynamic and pharmacokinetic study of pegylated liposomal doxorubicin combination (CCOP) chemotherapy in patients with peripheral T-cell lymphomas

Pharmacodynamic and pharmacokinetic study of pegylated liposomal doxorubicin combination (CCOP) chemotherapy in patients with peripheral T-cell lymphomas

The aggressive peripheral T‐cell lymphomas: 2015

Hematopoietic Cell Transplantation for Systemic Mature T-Cell Non-Hodgkin Lymphoma

Contact Info

Product

Resources

About