Peripheral T-cell lymphoma – pro
T-cell lymphomas are a relatively uncommon form of non-Hodgkin’s lymphoma (NHL) that generally do not respond as well to treatment as B-cell NHL. Peripheral T-cell lymphoma accounts for about one in 100 of all cases of NHL. It can occur at any age from young adulthood to old age and is slightly more common in men. There are various subtypes, some related to HIV or HTLV. Management of these disorders has been modeled after the treatment of aggressive B-cell lymphomas; however, therapeutic responses are not durable for most patients with PTCL. Given the rarity of PTCL, much of the literature consists of studies with small sample size and anecdotal case reports. Therefore, no consensus exists on the best therapeutic strategy for either newly diagnosed or relapsed/refractory PTCL. The NCCN guidelines for PTCL reflect this lack of conclusive data, and clinical trial participation is encouraged for all patients but also allogeneic abaltive or non-myeloablative therapy is mentioned.
For peripheral T-cell lymphoma, on p. TCELL-5 of 2011 NCCN Peripheral T-Cell lymphoma guideline, an allogeneic or autologous stem cell transplant is recommended for patients with partial or complete response.
Angioimmunoblastic T-cell lymphoma (AITL) is a type of peripehral T-cell lymphoma and one report states that treatment with allogeneic stem cell transplantation results in long-term disease-free survival in approximately 50% of patients. There are a number of other observational studies and retrospective reviews that confirm allogeneic transplant as an effective approach. There is no randomized evidence but such cannot be expected in this rare disease.
M. Hamadani, F. Awan, P. Elder, T. Lin, P. Porcu, K. Blum, S. Devine Allogeneic Hematopoietic Stem Cell Transplantation for Peripheral T Cell Lymphomas; Evidence of Graft-Versus-T Cell Lymphoma Effect Biology of Blood and Marrow Transplantation, Volume 14, Issue 4, Pages 480-483
Kyriakou C, Canals C, Finke J, et al. Allogeneic stem cell transplantation is able to induce long-term remissions in angioimmunoblastic T-cell lymphoma: A retrospective study from the Lymphoma Working Party of the European Group for Blood and Marrow Transplantation. Journal of Clinical Oncology [early online publication]. July 20, 2009.
le Gouill, S., Milpied, N., Buzyn, A., Socie, G., Mothy, M., Vernant, J., Ifrah, N., Haioun, C., Michallet, M., Volteau, C., Blaise, D.
Allogeneic stem cell transplantation (allo-SCT) in T-cell lymphomas: A French national survey from the Societe Francaise de Greffe de Moelle et de Therapie Cellulaire (SFGM-TC)
J Clin Oncol (Meeting Abstracts) 2007 25: 8095