First-Line and Second-Line T Cell Lymphoma Treatments

T cell lymphoma treatment options for these cancers are not especially effective and there is no absolute consensus about optimal treatments for most subtypes of T cell lymphoma because T cell lymphomas are relatively rare, representing about 15% of all non-Hodgkin's lymphomas diagnosed annually. Many T cell lymphoma subtypes, perhaps a majority, have a relatively poor prognosis with or without T cell lymphoma treatment.

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First-Line T Cell Lymphoma Treatment

First-line therapeutic intervention for cases of noncutaneous peripheral T cell lymphomas remains relatively poorly explored, but some chemotherapy regimens are advocated in widely published T cell lymphoma treatment guidelines, such as:

  • CHOP (cyclophosphamide, vincristine, doxorubucin and prednisone)
  • DA-EPOCH (etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin)
  • HyperCVAD (doxorubicin, vincristine, cyclophosphamide and dexamethasone)
  • High dose chemotherapy followed by a stem cell transplantation

Some T cell lymphoma patients may be guided towards a clinical trial as first-line therapy, depending on the diagnosis, staging, and other factors.

Second-Line T Cell Lymphoma Treatment

Second-line therapies for T cell lymphoma treatment include the following combination chemotherapy regimens, provided the patient is a candidate for stem cell transplantation:

  • DHAP (dexamethasone, cisplatin and cytarabine)
  • ESHAP (etopiside, methylprednisolone, cytarabine and cisplatin)
  • GDP (gemcitabine, dexamethasone and cisplatin
  • ICE (ifosfamide, carboplatin, etoposide)
  • MINE (mesna, ifosfamide, mitoxantrone and etoposide
  • Pralatrexate
  • GemOx (gemcitabine and oxaliplatin)

Similar to first-line options, for some patients referral to a clinical trial may constitute second-line therapy.

If the patient is not a candidate for stem cell transplantation, possible second-line therapies include the following:

  • Alemtuzumab
  • Bortezomib
  • Denileukin diftitox
  • Gemcitabine
  • Pralatrexate
  • Radiation

T cell lymphoma treatment options for less common T cell lymphoma subtypes, such as Adult T cell Leukemia/Lymphoma, as well as for cutaneous T cell lymphomas, will differ from what is presented here.

Source: National Comprehensive Cancer Network, Practice Guidelines in Oncology v.1., Peripheral T-Cell Lymphomas
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