Evaluation of enteropathy-associated T-cell lymphoma comparing standard therapies with a novel regimen including autologous stem cell transplantation

Sieniawski, Michal; Angamuthu, Nithia; Boyd, Kathryn; Chasty, Richard; Davies, J. M.; Forsyth, Peter; Jack, Fergus; Lyons, Simon; Mounter, Philip; Revell, Paul; Proctor, Stephen J.; Lennard, Anne

doi:10.1182/blood-2009-07-231324

Cited by 189 publications

(180 citation statements)

References 25 publications

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“…In that series, the 5-year survival rate was 20%, and the 5-year failure-free survival rate was 3% [90]. A recent report from the United Kingdom suggests that a better treatment outcome is possible in patients able to tolerate an aggressive chemotherapy regimen followed by an autologous transplant [91]. Of 26 patients treated with a regimen including ifosfamide, vincristine, etoposide, methotrexate, and an autologous transplant, the 5-year overall survival was 60%, and the 5-year progression-free survival 52%.…”

Section: Enteropathy-associated T-cell Lymphomamentioning

confidence: 82%

The aggressive peripheral T‐cell lymphomas: 2015

Armitage

2015

American J Hematol

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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.

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Section: Enteropathy-associated T-cell Lymphomamentioning

confidence: 82%

The aggressive peripheral T‐cell lymphomas: 2015

Armitage

2015

American J Hematol

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“…Therefore, HSCT should be considered a suitable consolidation therapy once an initial response is obtained, especially when autologous HSCT is applicable to the majority of patients because of absence of marrow infiltration. In fact, better survivals were also achieved in patients with classical EATL when treated with frontline autologous HSCT [23].…”

Section: Discussionmentioning

confidence: 99%

Type II enteropathy‐associated T‐cell lymphoma: A multicenter analysis from the Asia Lymphoma Study Group

et al. 2012

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Enteropathy-associated T-cell lymphoma (EATL) is a rare primary gastrointestinal T-cell lymphoma. A multicenter study from the Asia Lymphoma Study Group identified 38 EATL patients within a 19-year period. All cases were type II EATL. Men were affected twice as common as women, at a median age of 59 (23-89) years. None had a history of celiac disease. The sites of involvement were small bowel and stomach (5%), small bowel (63%), small and large bowel (16%), and large bowel (18%). Common presenting features were bowel perforation (34%), pain (32%), and obstruction (21%). Lymphomas showed monomorphic neoplastic lymphoid infiltrates that were CD3 1 (100%), CD56 1 (91%), TIA-1 1 (96%), CD4 -CD8 1 (63%), CD4 1 CD8 1 (19%), CD4 -CD8 -(16%), and CD4 1 CD8 -(3%). Epstein Barr virus was demonstrable in three cases. Despite chemotherapy and/or surgical resection, the overall response and complete response rates were poor at 46% and 38%. The median overall survival (OS) was 7 months and progression-free-survival (PFS) 1 month. Five patients underwent hematopoietic stem cell transplantation all were alive. Age and the prognostic index for peripheral T-cell lymphoma were not prognostically significant. Good performance status was associated with better OS (P 5 0.03), and response to initial treatment led to better OS and PFS (P < 0.001). Am. J. Hematol. 87:663-668, 2012. V

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“…The largest trial evaluating the role of ASCT was a prospective study from a population-based setting from the Scotland and Newcastle Lymphoma Group. 9 In this study, patients who received IVE/MTX (ifosfamide, etoposide, epirubicin, and methotrexate)-ASCT showed improved 5-year progression-free and overall survivals compared with those treated with a CHOP-like regimen (progression-free survival, 52% vs. 22%; overall survival, 60% vs. 22%).…”

Section: Discussionmentioning

confidence: 93%

“…The overall response rate varies from 30% to 60%, mostly using a CHOP-like regimen. [4][5][6][7][8][9] With current treatment strategies, the median overall survival is 10 months, with an estimated 5-year overall survival of 20%. 10 The most frequent cause of death involves intestinal complications of persistent disease, such as perforation and bleeding.…”

Section: Discussionmentioning

confidence: 99%

Brentuximab in the Treatment of CD30-Positive Enteropathy-Associated T-Cell Lymphoma

Khalaf¹,

Caldwell²,

Reddy³

2013

J Natl Compr Canc Netw

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Enteropathy-associated T-cell lymphoma (EATL) is a rare aggressive lymphoma that confers a poor prognosis with current treatment strategies. Given the rarity of this disease, prospective randomized trials are limited, and thus a standard validated treatment strategy is lacking. This report presents the disease course of a patient with EATL who was treated with single-agent brentuximab vedotin, an anti-CD30 conjugated antibody. (JNCCN 2013;11:137-140) NCCN: Continuing Education Accreditation StatementThis activity has been designated to meet the educational needs of physicians and nurses involved in the management of patients with cancer. There is no fee for this article. No commercial support was received for this article. The National Comprehensive Cancer Network (NCCN) is accredited by the ACCME to provide continuing medical education for physicians.NCCN designates this journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.NCCN is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center`s Commission on Accreditation.This activity is approved for 1.0 contact hour. Approval as a provider refers to recognition of educational activities only and does not imply ANCC Commission on Accreditation approval or endorsement of any product. Accredited status does not imply endorsement by the provider of the education activity (NCCN). Kristina M. Gregory, RN, MSN, OCN, is our nurse planner for this educational activity.All clinicians completing this activity will be issued a certificate of participation. To participate in this journal CE activity: 1) review the learning objectives and author disclosures; 2) study the education content; 3) take the posttest with a 70% minimum passing score and complete the evaluation at http://education.nccn.org/ node/11515; and 4) view/print certificate. Learning ObjectivesUpon completion of this activity, participants will be able to:• Describe the rationale for the management methods used in this case presentation.• Describe the ideal management of a patient taking brentuximab for the treatment of CD30-positive enteropathyassociated T-cell lymphoma. Ms. Harrold has disclosed that she has no relevant financial relationships. Kristina M. Gregory, RN, MSN, OCN, Vice President, Clinical Information OperationsMs. Gregory has disclosed that she has no relevant financial relationships. Case ReportA 64-year-old man presented with an acute small bowel obstruction that was preceded by a few months' history of intermittent diarrhea, fever, and weight loss. Pathology of the small bowel resection was consistent with enteropathy-associated T-cell lymphoma (EATL) that expressed CD3 and CD30; was negative for CD4, CD8,

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Evaluation of enteropathy-associated T-cell lymphoma comparing standard therapies with a novel regimen including autologous stem cell transplantation

Abstract: Enteropathy associated T-cell lymphoma (EATL) is

Cited by 189 publications

References 25 publications

The aggressive peripheral T‐cell lymphomas: 2015

The aggressive peripheral T‐cell lymphomas: 2015

Type II enteropathy‐associated T‐cell lymphoma: A multicenter analysis from the Asia Lymphoma Study Group

Brentuximab in the Treatment of CD30-Positive Enteropathy-Associated T-Cell Lymphoma

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