Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.
The need for aggressive chemotherapy (CT) in peripheral T-cell lymphoma (PTCL) (Meeting abstract).
Proc Annu Meet Am Soc Clin Oncol; 12:A1272 1993. Unique Identifier : AIDSLINE ICDB/94695671 Gil-Delgado M; Farabos C; Reynes M; Jasmin C; Musset M; Misset JL; ICIG, Hopital Paul-Brousse, 14 Av. Paul-Vaillant-Couturier, 94804; Villejuif, France
Abstract:
PTCL, described both in Japan and in Western countries, have been associated with poor outcome. As morphologically they can be classified both with intermediate- or low-grade lymphomas, lack of phenotype determination may result in suboptimal treatment. We have retrospectively reviewed 37 cases of unequivocal PTCL, 29 of which were seen at the onset of disease and are considered for the present analysis. In 3 patients (pts), PTCL was secondary to other hematologic malignancies (CLL, HCL and HD) and in 1 case AIDS related. Three expressed both CD4 and CD8 (but were CD1 negative), 3 expressed only CD8 and 20 only CD4, two of them CD30+. Three pts were positive with a pan-T antigen. 18 pts were male and 11 female. Median age 39 (range 19-68). The first clinical presentation was massive intrathoracic 1 pt, nodal 16 pts, cutaneous (mycosis fungoides excluded) 3 pts, disseminated 10 pts (including 1 leukemic with meningeal involvement). According to WF, 8/29 (27%) pts were diffuse large cells immunoblastic, 19/29 (65%) diffuse, large or mixed cells not immunoblastic, 2 'Lennert's NHL,' 1 angioimmunoblastic lymphadenopathy-like. Pts were treated with two approaches: (1) 17 had CHOP or CHOP-like regimen. (2) 12 had an intensive protocol q 3 wk x 6 mo: THP-ADM 10-20 mg/m2 days (d) 1-3, CPM 300 mg/m2 d 1-3 q (or PTC 20 mg/m2 d 1), VM-26 60 mg/m2 d 1 q, PDN 70 mg/m2 d 1-7, MTX 3 g/m2 d 8 + CF rescue, VCR 1.4 mg/m2 d 8, Ara-C 100-200 mg/m2 d 15 (+16), VDS 2 mg/m2 d 15. With (1) 6/17 pts (35%) achieved CR, median survival is 18 mo. Five (29% +/- 22) are long-term survivors (1 after salvage therapy), median 38 mo ranging from 12-69 mo. With (2) (including radiotherapy in 2 pts), 10/12 pts (83%) obtained CR. Duration of response ranges from 2-61+ mo, median 25 mo. Median survival is not reached at 39 mo, 8/12 pts (66% +/- 27) are alive free of disease. Although the difference does not reach statistical significance due to small numbers (p=0.1), the clinical trend supports the need for determination of immunophenotype as a part of pretherapeutic workup and aggressive CT in PTCL.
Keywords: Adult Aged Antineoplastic Agents, Combined/*THERAPEUTIC USE Bleomycin/ADMINISTRATION & DOSAGE Cyclophosphamide/ADMINISTRATION & DOSAGE Doxorubicin/*ANALOGS & DERIVATIVES/ADMINISTRATION & DOSAGE Female Human Immunophenotyping Lymphoma, T-Cell/CHEMISTRY/*DRUG THERAPY Male Middle Age Mitoxantrone/ADMINISTRATION & DOSAGE Prednisone/ADMINISTRATION & DOSAGE Teniposide/ADMINISTRATION & DOSAGE Tumor Markers, Biological Vincristine/ADMINISTRATION & DOSAGE ABSTRACT 940228
M9420818
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Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.
