FS25 Peripheral T-Cell Lymphoma Facts I page 5
Peripheral T-Cell Lymphoma Facts
a clinical trial is right for you. If you need help locating a
medical center near you or if you need assistance nding
an appropriate clinical trial, contact an LLS Information
Specialist by calling (800) 955-4572 or by going to the LLS
website at www.LLS.org/informationspecialists.
Peripheral T-Cell Lymphoma
Subtypes
Peripheral T-Cell Lymphoma, Not Otherwise
Specied (NOS)—Peripheral T-cell lymphoma,
NOS is the most common type of PTCL and
comprises a group of mixed T-cell diseases that do
not t into any of the other subtypes of PTCL.
Most patients with PTCL-NOS will have nodal
involvement, but extranodal sites, such as the liver,
bone marrow, gastrointestinal tract and skin, may
also be involved. is group of PTCLs is considered
aggressive and in the past has usually been treated
with standard CHOP (cyclophosphamide,
hydroxydoxorubicin [doxorubicin], Oncovin®
[vincristine], prednisone) chemotherapy at initial
diagnosis. However, since the chemotherapy
combination CHOP has not produced very good
outcomes, doctors are currently evaluating other
chemotherapy combinations for initial therapy.
Other drugs that may be eective in treating
patients who have PTCL-NOS include gemcitabine
(Gemzar®) and bortezomib (Velcade®), which are
showing response rates of about 60 percent and 30
percent, respectively. A number of small studies
have demonstrated disease-free survival rates of
between 35 percent and 45 percent in some patients
who received high-dose chemotherapy followed
by autologous stem cell transplantation. However,
larger studies need to be conducted to more
accurately assess the long-term eectiveness of this
type of treatment. Clinical trials evaluating newer
combinations of therapies are ongoing.
Anaplastic Large Cell Lymphoma—is rare
T-cell lymphoma constitutes about 3 percent of
all cases of lymphomas in adults and between 10
and 30 percent of all lymphomas in children. It
usually aects nodal sites, although extranodal
sites can also be involved. Anaplastic large cell
lymphoma (ALCL) is divided into two major
subtypes based on the presence or absence of a
protein called “anaplastic lymphoma kinase (ALK).”
Patients with ALK-positive disease usually have a
good response to the chemotherapy combination
CHOP (cyclophosphamide, hydroxydoxorubicin
[doxorubicin], Oncovin® [vincristine], prednisone)
and other similar chemotherapy combinations
and can achieve long-term remission or cure.
Brentuximab vedotin, (Adcetris®) also known
as SGN-35, is FDA approved for the treatment
of patients with systemic anaplastic large cell
lymphoma (ALCL) after failure of at least one
prior multi-agent chemotherapy regimen.
Brentuximab vedotin is administered by injection.
ALK-negative patients usually relapse and may need
more aggressive treatment, including high-dose
chemotherapy and a stem cell transplant.
Anaplastic Large Cell Lymphoma (Primary
Cutaneous)—Primary cutaneous ALCL is thought
to be a more indolent (slow-growing) lymphoma and
typically aects the skin. is lymphoma is usually
ALK negative, although the prognosis is fairly good.
Angioimmunoblastic T-Cell Lymphoma—
Angioimmunoblastic T-cell lymphoma (AITL)
accounts for between 1 percent and 2 percent
of all cases of NHL and typically follows an
aggressive course, although spontaneous disease
regression sometimes occurs. AITL usually occurs
in the lymph nodes and may aect the spleen or
liver. Some symptoms may include fever, weight
loss and rashes. e chemotherapy combination
CHOP (cyclophosphamide, hydroxydoxorubicin
[doxorubicin], Oncovin® [vincristine], prednisone)
has also been commonly used for this subtype of
lymphoma, but the results do not produce many
long-term disease-free survivors. For this subtype
of lymphoma, new chemotherapy combinations
either with or without stem cell transplantation are
being evaluated. For patients with relapsed disease,
therapies such as immunosuppressive agents or
targeted agents are being evaluated in clinical trials.
Nasal, Natural Killer (NK)/T-cell Lymphoma—
Extranodal nasal, NK/T-cell lymphoma typically
aects the nasal area and the paranasal sinus
areas behind the nose and cheeks, although the