Peripheral T-cell lymphomas: Initial features, natural history, and prognostic factors in a series of 174 patients diagnosed according to the R.E.A.L. Classification

Abstract

PTCL have adverse prognostic features at diagnosis, respond poorly to therapy and have short survival, with no sustained remission. ALCL constitutes a subgroup which responds better to therapy and has a longer survival.

Comparison of Long-Term Clinical Outcomes of CHOP Chemotherapy between Japanese Patients with Nodal Peripheral T-Cell Lymphomas and Those with Diffuse Large B-Cell Lymphoma in the Study Group of the Tohoku Hematology Forum

“…This finding was consistent with earlier reports in which CR rates for PTCLs ranged from 31% to 69%. 2,6,7,9,15,16 Furthermore, in the pre-rituximab era, the long-term remission rate was 50-60%, which is consistent with our result. If rituximab were combined with the CHOP regimen for CD20-positive DLBCL, the difference in CR rates between PTCLs and DLBCL would be expected to increase, as most studies have suggested that primary regimens containing rituximab improved the CR rate and long-term outcomes of DLBCL patients.…”

“…15,16 In Western countries, by contrast, high-risk groups account for only 42-46% of patients with PTCL. 2,9,17 Although the IPI for PTCLs appears to be higher in Japan than in Western countries, international studies with large patient populations will be required to confirm the racial differences in the clinical characteristics of PTCLs.…”

“…2,7,8 Indeed, long-term disease-free survival (DFS) is achieved in only 20-30% of patients with PTCL. 2,[6][7][8][9][10] However, these results showed substantial heterogeneity due to the inclusion in the PTCL group of patients with ALKpositive ALCL, which has a significantly better outcome than DLBCL. [11][12][13] To clarify the clinical outcome of PTCLs, we conducted a retrospective review of patients with PTCL, including nodal PTCL-u (n＝34) and AITL (n＝12), who were treated using a CHOP regimen (cyclophosphamide, doxorubicin, vincristine, and prednisolone).…”

The Outcome of HyperCVAD Combined with Alemtuzumab for the Treatment of Aggressive T-Cell and NK-Cell Neoplasms

“…However, the clinical outcome is poor with this therapy except for anaplastic large-cell lymphoma (ALCL), ALK positive type [2]. Large prospective series did indicate a higher relapse rate and a poorer survival for PTCL than DLBCL [2,[5][6][7][8][9][10][11][12][13]. Various chemotherapy regimens have been tried out--such as MegaCHOP (intensive or higher dose of CHOP) with or without etoposide [14,15], epirubicin substituted for doxorubicin and addition of bleomycin (CEOP-B) [16], CMED (cyclophosphamide, etoposide, methotrexate, and dexamethasone) [17], CHOP or MegaCHOP/ESHAP (etoposide, cisplatin, cytarabine and prednisone) [18,19] and VCAP-AMP-VECP (vincristine, cyclophosphamide, doxorubicin, and prednisone (VCAP); doxorubicin, ranimustine, and prednisone (AMP); vindesine, etoposide, carboplatin, and prednisone (VECP)) [20]; fractionated cyclophosphamide, vincristine, doxorubicin and dexamethasone alternating with high doses of methotrexate and cytarabine (hyperCVAD) [21,22]--with no superior efficacy to CHOP except CMED at the expense of higher treatment toxicity.…”

Autologous hematopoietic stem cell transplantation in peripheral T-cell lymphoma using a uniform high-dose regimen

“…2 Retrospective analyses using WHO criteria have generally found a worse outcome for PTCL (long-term overall survival (OS) 26-41%) than that seen for B-cell lymphoma following conventional chemotherapy, especially if anaplastic large-cell lymphoma (ALCL), a good prognosis subtype of PTCL, is excluded. 1,[3][4][5][6] The favorable outcome of ALCL (60% OS at 5 years after standard therapy) is associated with the expression of anaplastic lymphoma kinase (ALK), seen in half of the cases. 4,5,7,8 In general, the initial chemosensitivity but poor ultimate outcome of PTCL has fueled interest in high-dose therapy and autologous stem cell transplantation (ASCT) as a means to improve cure rates.…”