Post-Conference Perspectives: Peripheral T-Cell Lymphoma - Episode 6
Stephen Ansell, MD, PhD: Well, non-Hodgkin lymphoma is a kind of malignancy of lymphocytes, or parts of your immune system, and lymphomas typically are B-cell lymphomas. But 10% of patients have peripheral T-cell lymphoma. There are many different histological types, so it’s really a lumping of all of the diseases together; not as common as the B-cell lymphomas but commonly difficult to treat, really for 2 reasons. One is, those diseases tend to be a little more resistant to therapy. Many of them are diagnosed a little later because their presentations can be atypical or unusual. And, additionally, the tools we have to actually treat the patients tend to be a little more rudimentary than B-cell lymphomas, in large part because we haven’t had antibodies to target the malignant cell. So, all told, peripheral T-cell lymphoma remains a challenge—not a common one, but one that certainly is in need of new therapies.
I think for many years, peripheral T-cell lymphomas have really been treated based on what we knew from B-cell lymphomas. So the standard therapy for B-cell lymphomas became CHOP [cyclophosphamide, doxorubicin, vincristine (Oncovin), and prednisone] chemotherapy and then subsequently R-CHOP chemotherapy with the addition of rituximab. Clearly, rituximab didn’t have a use in T-cell lymphoma, so CHOP chemotherapy has been the backbone. There have been a lot of people over the years who have debated whether that truly is the best backbone, but I think in the absence of other more compelling data, that’s been kind of the way in which we’ve built therapy. And so commonly, the addition of other chemotherapies to the CHOP backbone, or autologous stem cell transplant done after CHOP chemotherapy, or the attempt to add other antibodies to CHOP chemotherapy, have been strategies that have been tried moving forward and tried to improve the outcome of patients with T-cell lymphoma. Really, to date, we’ve had limited success. Many agents that have been added to CHOP chemotherapy over the years have been unsuccessful in really creating a better outcome for patients with peripheral T-cell lymphoma.
Transcript Edited for Clarity