Current Treatment of Peripheral T-cell Lymphoma.

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From: Oncology(Vol. 36, Issue 5)
Publisher: Intellisphere, LLC
Document Type: Article
Length: 7,539 words
Lexile Measure: 1820L

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Abstract :

The peripheral T-cell lymphomas [PTCLs] are a notoriously diverse family of non-Hodgkin lymphomas with generally aggressive biology. Clinical management is challenging given a largely inadequate literature base comprised of few randomized trials and heterogeneous observational reports. Herein, we provide an account of our practice in the treatment of the 3 most common nodal PTCLs: PTCL, not otherwise specified, angioimmunoblastic T-cell lymphoma, and anaplastic large cell lymphoma CALCL). In the up-front setting, we employ anthracycline-based induction, with the incorporation of brentuximab vedotin for all those with ALCL and consideration in those with other CD30-expressing PTCLs based on improved progression-free and overall survival in the absence of additional toxicity in the ECHELON-2 trial. We strongly consider high-dose therapy with autologous stem cell rescue in first complete remission. In the relapsed or refractory CR/R] setting, we often look to clinical trials or choose from 4 FDA-approved single agents--belinostat, brentuximab vedotin, romidepsin, and pralatrexate--based on tumor phenotype and side-effect profiles. Our goal in the R/R setting is achievement of complete remission followed by allogeneic transplant with curative intent in appropriate candidates or long-term disease control in others. Numerous investigational agents are advancing through trials and have potential to alter standards of care in the near future.

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Gale Document Number: GALE|A704419379