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Bangolo A, Fwelo P, Dey S, Sethi T, Sagireddy S, Chatta J, Goel A, Nagpaul S, Chen EPS, Saravanan C, Gangan S, Thomas J, Potiguara S, Nagesh VK, Elias D, Mansour C, Ratnaparkhi PH, Jain P, Mathew M, Porter T, Sultan S, Abbisetty S, Tran L, Chawla M, Lo A, Weissman S, Cho C. Characteristics and distinct prognostic determinants of individuals with hepatosplenic T-cell lymphoma over the past two decades. World J Clin Oncol 2024; 15:745-754. [PMID: 38946833 PMCID: PMC11212601 DOI: 10.5306/wjco.v15.i6.745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 05/01/2024] [Accepted: 05/21/2024] [Indexed: 06/24/2024] Open
Abstract
BACKGROUND Hepatosplenic T-cell lymphoma (HSTCL) is a rare and aggressive peripheral T-cell lymphoma with historically dismal outcomes, representing less than one percent of non-Hodgkin lymphomas. Given its rarity, the true incidence of HSTCL is unknown and most data have been extrapolated through case reports. To the best of our knowledge, the largest and most up to date study addressing the epidemiology and outcomes of patients with HSTCL in the United States covered a period from 1996 to 2014, with a sample size of 122 patients. AIM To paint the most updated epidemiological picture of HSTCL. METHODS A total of 186 patients diagnosed with HSTCL, between 2000 and 2017, were ultimately enrolled in our study by retrieving data from the Surveillance, Epidemiology, and End Results database. We analyzed demographics, clinical characteristics, and overall mortality (OM) as well as cancer-specific mortality (CSM) of HSTCL. Variables with a P value < 0.01 in the univariate Cox regression were incorporated into the multivariate Cox model to determine the independent prognostic factors, with a hazard ratio of greater than 1 representing adverse prognostic factors. RESULTS Male gender was the most represented. HSTCL was most common in middle-aged patients (40-59) and less common in the elderly (80+). Non-Hispanic whites (60.75%) and non-Hispanic blacks (20.97%) were the most represented racial groups. Univariate Cox proportional hazard regression analysis of factors influencing all-cause mortality showed a higher OM among non-Hispanic black patients. CSM was also higher among non-Hispanic blacks and patients with distant metastasis. Multivariate Cox proportional hazard regression analysis of factors affecting CSM revealed higher mortality in patients aged 80 or older and non-Hispanic blacks. CONCLUSION Overall, the outlook for this rare malignancy is very grim. In this retrospective cohort study of the United States population, non-Hispanic blacks and the elderly had a higher CSM. This data highlights the need for larger prospective studies to investigate factors associated with worse prognosis in one ethnic group, such as treatment delays, which have been shown to increase mortality in this racial/ethnic group for other cancers.
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Affiliation(s)
- Ayrton Bangolo
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Pierre Fwelo
- Department of Epidemiology, Human Genetics, and Environmental Sciences, UTHealth School of Public Health, Houston, TX 77030, United States
| | - Shraboni Dey
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Tanni Sethi
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Sowmya Sagireddy
- Department of Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Jawaria Chatta
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Ashish Goel
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Sneha Nagpaul
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Eric Pin-Shiuan Chen
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Chiranjeeve Saravanan
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Sheeja Gangan
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Joel Thomas
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Sarah Potiguara
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Vignesh K Nagesh
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Daniel Elias
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Charlene Mansour
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Prajakta H Ratnaparkhi
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Priyanshu Jain
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Midhun Mathew
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Taylor Porter
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Shadiya Sultan
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Shailaja Abbisetty
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Linh Tran
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Megha Chawla
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Abraham Lo
- Department of Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Simcha Weissman
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Christina Cho
- Stem Cell Transplantation and Cellular Therapy, John Theurer Cancer Center, Hackensack, NJ 07601, United States
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2
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Moustafa MA, Ramdial JL, Tsalatsanis A, Khimani F, Dholaria B, Bojanini L, Brooks T, Zain J, Bennani NN, Braunstein Z, Brammer JE, Beitinjaneh A, Jagadeesh D, Weng WK, Kumar A, Kharfan-Dabaja MA, Ahmed S, Murthy HS. A US Multicenter Collaborative Study on Outcomes of Hematopoietic Cell Transplantation in Hepatosplenic T-Cell Lymphoma. Transplant Cell Ther 2024; 30:516.e1-516.e10. [PMID: 38431075 DOI: 10.1016/j.jtct.2024.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 02/16/2024] [Accepted: 02/20/2024] [Indexed: 03/05/2024]
Abstract
Hepatosplenic T-cell lymphoma (HSTCL) is a rare and aggressive type of peripheral T-cell lymphoma with median overall survival (OS) of approximately 1 year. Data on the effectiveness of hematopoietic cell transplantation (HCT) is limited, as is the choice between autologous HCT (auto-HCT) and allogeneic HCT (allo-HCT) in the treatment of this disease. To evaluate the outcome of patients with HSTCL who underwent either auto-HCT or allo-HCT, we performed a multi-institutional retrospective cohort study to assess outcomes of HCT in HSTCL patients. Fifty-three patients with HSTCL were included in the study. Thirty-six patients received an allo-HCT and 17 received an auto-HCT. Thirty-five (66%) were males. Median age at diagnosis was 38 (range 2 to 64) years. Median follow-up for survivors was 75 months (range 8 to 204). The median number of prior lines of therapy was 1 (range 1 to 4). Median OS and progression-free survival (PFS) for the entire cohort were 78.5 months (95% CI: 25 to 79) and 54 months (95% CI: 18 to 75), respectively. There were no significant differences in OS (HR: 0.63, 95% CI: 0.28 to 1.45, P = .245) or PFS (HR: 0.7, 95% CI: 0.32 to 1.57, P = .365) between the allo-HCT and auto-HCT groups, respectively. In the allo-HCT group, the 3-year cumulative incidence of relapse was 35% (95% CI: 21 to 57), while 3-year cumulative incidence of NRM was 16% (95% CI: 7 to 35). In the auto-HCT group, the 3-year cumulative incidence of relapse and NRM were 43% (95% CI: 23 to 78) and 14% (95% CI: 4 to 52), respectively. Both Auto-HCT and Allo-HCT are effective consolidative strategies in patients with HSTCL, and patients should be promptly referred for HCT evaluation.
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Affiliation(s)
| | - Jeremy L Ramdial
- Department of Lymphoma/Myeloma and Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Athanasios Tsalatsanis
- Department of Internal Medicine, Research Methodology and Biostatistics Core, Office of Research, University of South Florida Morsani College of Medicine, Tampa, Florida
| | - Farhad Khimani
- Blood and Marrow Transplantation and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Bhagirathbhai Dholaria
- Medicine, Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Leyla Bojanini
- Stanford University School of Medicine, Palo Alto, California
| | - Taylor Brooks
- Hematology and Medical Oncology, Cleveland Clinic, Cleveland, Ohio
| | - Jasmine Zain
- Hematology/Hematopoietic Cell Transplant, City of Hope National Medical Center, Duarte, California
| | | | - Zachary Braunstein
- Department of Internal Medicine, Ohio State University Wexner Medical Columbus, Columbus, Ohio
| | - Jonathan E Brammer
- Division of Hematology, Department of Internal Medicine, James Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio
| | - Amer Beitinjaneh
- Division of Transplantation and Cellular Therapy, University of Miami, Miami, Florida
| | - Deepa Jagadeesh
- Hematology and Medical Oncology, Cleveland Clinic, Cleveland, Ohio
| | - Wen Kai Weng
- Division of BMT and Cellular Therapy, Stanford University School of Medicine, Stanford, California
| | - Ambuj Kumar
- Department of Internal Medicine, Research Methodology and Biostatistics Core, Office of Research, University of South Florida Morsani College of Medicine, Tampa, Florida
| | | | - Sairah Ahmed
- Department of Lymphoma/Myeloma and Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Hemant S Murthy
- Division of Hematology and Medical Oncology, Mayo Clinic, Jacksonville, Florida.
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Call J, Mai W, Chirila R. 53-Year-Old Man With Fever and Hepatomegaly. Mayo Clin Proc 2024; 99:312-317. [PMID: 38189690 DOI: 10.1016/j.mayocp.2023.05.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 05/30/2023] [Accepted: 05/31/2023] [Indexed: 01/09/2024]
Affiliation(s)
- Justin Call
- Resident in Internal Medicine, Mayo Clinic School of Graduate Medical Education, Jacksonville, FL
| | - William Mai
- Resident in Internal Medicine, Mayo Clinic School of Graduate Medical Education, Jacksonville, FL
| | - Razvan Chirila
- Advisor to residents and Consultant in General Internal Medicine, Mayo Clinic, Jacksonville, FL.
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4
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Chen C, Yang F, Miu P, Shi P, Qian S. Allo-HSCT with TBI-based preconditioning for hepatosplenic T-cell lymphoma: two case reports and systematic review of literature. Front Oncol 2024; 14:1345464. [PMID: 38347837 PMCID: PMC10859473 DOI: 10.3389/fonc.2024.1345464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 01/11/2024] [Indexed: 02/15/2024] Open
Abstract
Hepatosplenic T cell lymphoma (HSTCL) is a particularly difficult-to-treat form of lymphoma, with many patients exhibiting primary resistance to chemotherapy. At present, no effective strategy for treating relapsed and refractory HSTCL has been established, with treatment being hampered by questions of how best to overcome chemoresistance to allow patients to attain more durable therapeutic benefits. While there have been marked advances in immunotherapy, allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains one of the primary approaches to curing HSTCL. Of patients who undergo immunochemotherapeutic treatment, many are resistant to conventional chemotherapeutic drugs yet remain sensitive to radiotherapy. We selected to employ a transplant pretreatment regimen consisting of total -body irradiation (TBI) and administered this regimen to two patients with HSTCL. Both patients achieved complete remission (CR) after transplantation, demonstrating extended periods without disease recurrence. We systematic reviewed previously published instances involving allo-HSCT in patients with HSTCL. We have found a total of 67 patients who have received allo-HSCT. In general, age<45 and the status of CR at HSCT may have a more favorable prognosis. Although the impact of TBI on prognosis was not found to be substantial, patients in the TBI group had higher 3-year overall survival (66.7% vs. 71.1%) and 5-year overall survival (58.4% vs. 71.1%) compared to patients in the non-TBI group. In addition, the relapse rate of the TBI group is approximately half that of the non-TBI group. This regimen is well tolerated and associated with low recurrence rates or complications, suggesting that it represents a viable pretreatment regimen for young HSTCL patients undergoing allogeneic HSCT.
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Affiliation(s)
- Can Chen
- Department Of Hematology, Hangzhou First People’s Hospital, Hangzhou, China
| | - Fan Yang
- Department Of Hematology, Hangzhou First People’s Hospital, Hangzhou, China
| | - Peiwen Miu
- Fourth Clinical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Pengfei Shi
- Department Of Hematology, Hangzhou First People’s Hospital, Hangzhou, China
| | - Shenxian Qian
- Department Of Hematology, Hangzhou First People’s Hospital, Hangzhou, China
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Gaillard JB, Chapiro E, Daudignon A, Nadal N, Penther D, Chauzeix J, Nguyen-Khac F, Veronese L, Lefebvre C. Cytogenetics in the management of mature T-cell and NK-cell neoplasms: Guidelines from the Groupe Francophone de Cytogénétique Hématologique (GFCH). Curr Res Transl Med 2023; 71:103428. [PMID: 38016421 DOI: 10.1016/j.retram.2023.103428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 11/30/2023]
Abstract
Mature T-cell and natural killer (NK)-cell neoplasms (MTNKNs) are a highly heterogeneous group of lymphomas that represent 10-15 % of lymphoid neoplasms and have usually an aggressive behavior. Diagnosis can be challenging due to their overlapping clinical, histological and immunophenotypic features. Genetic data are not a routine component of the diagnostic algorithm for most MTNKNs. Indeed, unlike B-cell lymphomas, the genomic landscape of MTNKNs is not fully understood. Only few characteristic rearrangements can be easily identified with conventional cytogenetic methods and are an integral part of the diagnostic criteria, for instance the t(14;14)/inv(14) or t(X;14) abnormality harbored by 95 % of patients with T-cell prolymphocytic leukemia, or the ALK gene translocation observed in some forms of anaplastic large cell lymphoma. However, advances in molecular and cytogenetic techniques have brought new insights into MTNKN pathogenesis. Several recurrent genetic alterations have been identified, such as chromosomal losses involving tumor suppressor genes (SETD2, CDKN2A, TP53) and gains involving oncogenes (MYC), activating mutations in signaling pathways (JAK-STAT, RAS), and epigenetic dysregulation, that have improved our understanding of these pathologies. This work provides an overview of the cytogenetics knowledge in MTNKNs in the context of the new World Health Organization classification and the International Consensus Classification of hematolymphoid tumors. It describes key genetic alterations and their clinical implications. It also proposes recommendations on cytogenetic methods for MTNKN diagnosis.
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Affiliation(s)
- Jean-Baptiste Gaillard
- Unité de Génétique Chromosomique, Service de Génétique moléculaire et cytogénomique, CHU Montpellier, Montpellier, France.
| | - Elise Chapiro
- Centre de Recherche des Cordeliers, Sorbonne Université, Université Paris Cité, Inserm UMRS_1138, Drug Resistance in Hematological Malignancies Team, F-75006 Paris, France; Sorbonne Université, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Service d'Hématologie Biologique, F-75013 Paris, France
| | - Agnès Daudignon
- Institut de Génétique Médicale - Hôpital Jeanne de Flandre - CHRU de Lille, France
| | - Nathalie Nadal
- Service de génétique chromosomique et moléculaire, CHU Dijon, Dijon, France
| | - Dominique Penther
- Laboratoire de Génétique Oncologique, Centre Henri Becquerel, Rouen, France
| | - Jasmine Chauzeix
- Service d'Hématologie biologique CHU de Limoges - CRIBL, UMR CNRS 7276/INSERM 1262, Limoges, France
| | - Florence Nguyen-Khac
- Centre de Recherche des Cordeliers, Sorbonne Université, Université Paris Cité, Inserm UMRS_1138, Drug Resistance in Hematological Malignancies Team, F-75006 Paris, France; Sorbonne Université, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Service d'Hématologie Biologique, F-75013 Paris, France
| | - Lauren Veronese
- Service de Cytogénétique Médicale, CHU Estaing, 1 place Lucie et Raymond Aubrac, 63003 Clermont-Ferrand; EA7453 CHELTER, Université Clermont Auvergne, France
| | - Christine Lefebvre
- Unité de Génétique des Hémopathies, Service d'Hématologie Biologique, CHU Grenoble Alpes, Grenoble, France
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Lee S, Kito Y, Fujita K, Wakayama H, Kimura M, Kawashima K, Tabata T, Yoshino T, Hara T, Tsurumi H. An unusual case of hepatosplenic T-cell lymphoma-like unclassifiable T/NK-cell lymphoma accompanied by acute myeloid leukemia. EJHAEM 2022; 3:1335-1338. [PMID: 36467833 PMCID: PMC9713219 DOI: 10.1002/jha2.565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 08/24/2022] [Indexed: 06/17/2023]
Abstract
We describe a case of unclassifiable T/NK-cell lymphoma with concomitant acute myeloid leukemia (AML). A 73-year-old Japanese man was diagnosed with AML by bone marrow smear, but the presence of splenomegaly and liver tumor was incompatible with AML. Splenectomy and hepatic resection were performed to resolve the thrombocytopenia and define the diagnosis. The pathological findings showed sinusoidal involvement of abnormal lymphoid cells that were CD3-positive but negative for T-cell receptor (TCR) rearrangement. Our case could not be categorized as hepatosplenic T-cell lymphoma because of the lack of immunohistological expression of TCR, despite the clinical similarity.
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Affiliation(s)
- Shin Lee
- Department of Hematology and OncologyMatsunami General HospitalGifuJapan
| | - Yusuke Kito
- Department of PathologyMatsunami General HospitalGifuJapan
| | - Kei Fujita
- Department of Hematology and OncologyMatsunami General HospitalGifuJapan
| | - Hiroto Wakayama
- Department of Hematology and OncologyMatsunami General HospitalGifuJapan
| | - Masaki Kimura
- Department of Gastrointestinal SurgeryMatsunami General HospitalGifuJapan
| | | | - Tetsuya Tabata
- Department of PathologyOkayama University Graduate School of MedicineDentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Tadashi Yoshino
- Department of PathologyOkayama University Graduate School of MedicineDentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Takeshi Hara
- Department of Hematology and OncologyMatsunami General HospitalGifuJapan
| | - Hisashi Tsurumi
- Department of Hematology and OncologyMatsunami General HospitalGifuJapan
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Liu J, Fang JC, Zhong L. Effective treatment with programmed cell death protein-1 antibody, chidamide and conventional chemotherapy for hepatosplenic γδ T-cell lymphoma: A case report and literature review. J Dig Dis 2022; 23:50-53. [PMID: 34807523 DOI: 10.1111/1751-2980.13068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 11/14/2021] [Accepted: 11/18/2021] [Indexed: 12/11/2022]
Affiliation(s)
- Jia Liu
- Department of Hematology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jian Chen Fang
- Department of Pathology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Lu Zhong
- Department of Hematology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Bron D, De Leval L, Michiels S, Wittnebel S. Hepatosplenic T-cell lymphoma: treatment challenges. Curr Opin Oncol 2021; 33:406-411. [PMID: 34409955 DOI: 10.1097/cco.0000000000000775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Hepatosplenic lymphoma (HSTCL) is a rare T-cell malignancy occurring in young males, associated with immune deficiency in 20% of the cases which, despite aggressive treatments, has a poor survival. Specific recommendations for first-line treatment remain debatable. RECENT FINDINGS Published data covering case reports or series of HSTCL concur that allogeneic stem cell transplant should be proposed as a consolidation after response to chemotherapy in all patients eligible for transplant. In the light of two recent clinical examples, we also confirm that specific chemotherapy and a first-line consolidation with allogeneic transplantation when a donor is available to represent a treatment of choice these rare and distinctive lymphomas. Recent molecular studies are summarized in this review and suggest potential targets for new therapeutic strategies. SUMMARY Major progresses have been achieved in improving the outcome of HSTCL l patients using intensive chemotherapy and allogeneic transplantation.
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Affiliation(s)
- Dominique Bron
- Department of Hematology, Institut Jules Bordet (ULB), Brussels, Belgium
| | - Laurence De Leval
- Institute of Pathology, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland
| | - Sandra Michiels
- Department of Hematology, Institut Jules Bordet (ULB), Brussels, Belgium
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Clinical features and treatment outcomes of 14 patients with hepatosplenic γ δ T-cell lymphoma. J Cancer Res Clin Oncol 2021; 147:3441-3445. [PMID: 33856526 DOI: 10.1007/s00432-021-03587-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 03/07/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Hepatosplenic γ δ T-cell lymphoma (HSTCL) is a rare subtype of peripheral T-cell lymphoma (PTCL) with aggressive clinical behavior. To date, no standard therapy for HSTCL has been established. This study analyzed the clinical features, treatment, and prognosis for patients with HSTCL to determine the best therapeutic approach. METHODS We reviewed the clinical characteristics, treatments, and responses to treatment of patients in our center between January 2001 and June 2021, and also reviewed related literature. RESULTS Median patient age was 38 years (range 16-60 years) and the patients included eight males and six females. HSTCL in these patients typically presented with B symptoms (71.4%), splenomegaly (100%), and hepatomegaly (50.0%), but lymphadenopathy was extremely rare. In these patients, routine laboratory testing showed elevated lactate dehydrogenase (71.4%), liver dysfunction (42.9%), and decreased fibrinogen (35.7%). In the induction phase, five of the 14 patients received chemotherapy regimens containing anthracycline (CHOP, or CHOP plus bortezomib or Chidamide), and six were treated with non-CHOP chemotherapy. Seven patients responded to induction treatment, four of whom received allogeneic hematopoietic cell transplantation and then achieved a complete response in the consolidation phase. survival time of patients who received alloHCT range from 10 to 27 months. CONCLUSION Hepatosplenic γ δ T-cell lacks a standard therapy and is often refractory to conventional chemotherapy regimens. Intensive induction chemotherapy followed by hematopoietic cell transplantation may improve the prognosis of HSTCL.
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