T-cell lymphomas constitute about 10-15 per cent of all Non-Hodgkin’s lymphomas.
T-cell lymphomas can be classified into various subtypes depending upon the shape size and other cellular characteristics of the tumors. Classification of these tumors is also complicated with most tumors being different from the others. In general, T-cell lymphomas can be divided into several categories:
- Peripheral T-cell Lymphoma
- Cutaneous T-cell Lymphoma
- Angioimmunoblastic T-cell lymphoma
- Adult T-cell Lymphoma (also termed as adult T-cell leukemia or HTLV-1)
T-cell lymphomas can also be classified according to the cell type and site or origin as follows:
- Acute lymphocytic lymphoma (leukemia)
- Chronic lymphocytic lymphoma
- Acute myeloid lymphoma
- Chronic myeloid lymphoma
Lymphocytic leukemias are cancers where the precursors T-cells originate from the lymph nodes whereas myeloid leukemias are those where the precursor cells come from the bone marrow. Lymphomas can arise from the lymph nodes situated all over the body and are also named according to the tissue of origin. Therefore an evaluation of cell types present in biopsy tissue samples is the only definitive tool to identify T-cell lymphomas.
Causes
The exact cause of most T-cell lymphomas is unknown. However, it is likely that genetic changes that take place during antigen processing and presentation are likely to result in an aggressively dividing cell population, some of which may give rise to T-cell lymphoma. A definitive infective agent, a virus named as HTLV-1 has been shown to cause Adult T-cell leukemia / lymphoma.
Adult T-cell lymphomas are caused by the virus Human Lymphotropic Virus-1 (HTLV-1). This is an aggressive lymphoma with four subtypes:
- Acute
- Lymphocytic
- Chronic
- Smouldering
The first two forms are quite aggressive. Chronic and smouldering adult T-cell leukemias are slow growing (1). Although the HTLV-1 virus is present in some ethnic populations like Japan, South America and Caribbean people, only 2-5 percent of the total number of infected people develop the disease.
Treatment
T-cell lymphomas are treated using combinatorial chemotherapy regimes. A few commonly used therapy regimes are:
- CHOP: This regime comprises of cyclophosphamide, doxorubicin, vincristine and prednisone.
- EPOCH: This strategy includes etoposide, doxorubicin, vincristine, cyclophosphamide and prednisone
- ICE: This regime includes ifosfamide, carboplatin and etoposide
- GND: Gemcitabine in combination with vinorelbine and doxorubicin are administered in this regime. This drug combination is seen to be very effective in patients suffering from a relapse after having undergone treatment with the CHOP or EPOCH regimes.
- Cancer Patients have more options through clinical studies. Follow this link to learn more and find a clinical study opportunity near you.
The choice of therapeutic agents should be made in consultation with your oncologist considering other risk factors (eg. Age, health, aggressive or indolent tumor etc.).
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