VCAP-AMP-VECP Compared With Biweekly CHOP for Adult T-Cell Leukemia-Lymphoma: Japan Clinical Oncology Group Study JCOG9801

Abstract

The longer OS at 3 years and higher CR rate with VCAP-AMP-VECP compared with biweekly CHOP suggest that VCAP-AMP-VECP might be a more effective regimen at the expense of higher toxicities, providing the basis for future investigations in the treatment of ATLL.

Galectin-9 as a Predictive Marker for the Onset of Immune-Related Adverse Effects Associated with Anti-CCR4 MoAb Therapy in Patients with Adult T Cell Leukemia

“…Adult T-cell leukemia/lymphoma (ATL/ATLL) was established as a distinct clinical entity in Japan in 1977 (Uchiyama et al 1977), and it is associated with a poor prognosis (Tsukasaki et al 2007). ATL/ATLL cells were initially shown to be positive for mature T-cell surface antigens CD3, CD4, and CD25, and negative for CD8 with rare occasions of double negativity or double positivity for CD4 and CD8 (Hattori et al 1981;Hattori et al 1991).…”

Characteristic patterns of relapse after allogeneic hematopoietic SCT for adult T-cell leukemia–lymphoma: a comparative study of recurrent lesions after transplantation and chemotherapy by the Nagasaki Transplant Group

“…The unfavorable chronic type of ATL was defined according to previous criteria. 4 The diagnosis of ATL was based on clinical features, histologically and/or cytologically proven mature T-cell malignancy, the presence of the anti-HTLV-1 Ab and the monoclonal integration of HTLV-1 original DNA into tumor cells, as described previously. 2,23,24 A total of 336 patients were excluded from the 497 patients whose data were available because they did not achieve CR after CHT or allo-SCT (Figure 1).…”

“…The intrathecal administration of CHT as prophylaxis for CNS relapse was performed based on the decision of clinicians before 2007, and was then routinely performed after 2007 as described previously in a phase III clinical trial for aggressive ATL. 4 No patient received mogamulizumab before achieving the first CR. Relapse after the first CR was observed in 79 of the remaining 161 patients, and these patients were included in this analysis.…”

“…2 ATL is resistant to various cytotoxic agents and has a poor prognosis. 3,4 Allogeneic hematopoietic SCT (allo-SCT) for patients with aggressive ATL (acute, lymphoma and the unfavorable chronic type) is considered to be a therapeutic option that can provide apparent durable remission along with graft-vs-ATL effects. [5][6][7][8][9][10][11][12][13][14][15][16][17][18] However, both the relapse rate and TRM after allo-SCT were previously shown to be high, and are urgent issues that need to be addressed.…”

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

“…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. Gemcitabine-based chemotherapies are emerging and seem quite compromising [23][24][25][26][27].…”