Difference between revisions of "Adult T-cell leukemia-lymphoma"
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====Supportive medications==== | ====Supportive medications==== | ||
| − | *[[Filgrastim (Neupogen)]] given once | + | *[[Filgrastim (Neupogen)]] given once ANC decreased to less than 1000/uL and continued once per day until count increased to greater than 5000/uL |
'''14-day cycle for 8 cycles''' | '''14-day cycle for 8 cycles''' | ||
====Intrathecal component==== | ====Intrathecal component==== | ||
| − | ''Intrathecal triple-therapy was given during recovery phase of cycles 1, 3, and 5 after platelet count was > | + | ''Intrathecal triple-therapy was given during recovery phase of cycles 1, 3, and 5 after platelet count was greater than 70 × 10<sup>9</sup>/L.'' |
*[[Cytarabine (Cytosar)]] 40 mg IT | *[[Cytarabine (Cytosar)]] 40 mg IT | ||
*[[Methotrexate (MTX)]] 15 mg IT | *[[Methotrexate (MTX)]] 15 mg IT | ||
| Line 112: | Line 112: | ||
|style="background-color:#00CD00"|Seems to have superior CR rate | |style="background-color:#00CD00"|Seems to have superior CR rate | ||
|- | |- | ||
| − | |[ | + | |[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5024033/ Ishida et al. 2015] |
|style="background-color:#00CD00"|Randomized Phase II | |style="background-color:#00CD00"|Randomized Phase II | ||
|[[Mogamulizumab_(KW-0761)#Adult_T-cell_leukemia-lymphoma|mLSG15 & mogamulizumab]] | |[[Mogamulizumab_(KW-0761)#Adult_T-cell_leukemia-lymphoma|mLSG15 & mogamulizumab]] | ||
| Line 134: | Line 134: | ||
*[[Cytarabine (Cytosar)]] 40 mg mixed with [[Methotrexate (MTX)]] 15 mg and [[Prednisone (Sterapred)]] 10 mg IT | *[[Cytarabine (Cytosar)]] 40 mg mixed with [[Methotrexate (MTX)]] 15 mg and [[Prednisone (Sterapred)]] 10 mg IT | ||
| − | '''Given after cycles 1, 3, and 5 after platelets | + | '''Given after cycles 1, 3, and 5 after platelets greater than 70 × 10<sup>9</sup>/L and within 2 days before the next cycle''' |
===References=== | ===References=== | ||
<!-- Presented in part at the 47th Annual Meeting of the American Society of Hematology, December 10-13, 2005, Atlanta, GA. --> | <!-- Presented in part at the 47th Annual Meeting of the American Society of Hematology, December 10-13, 2005, Atlanta, GA. --> | ||
# Tsukasaki K, Utsunomiya A, Fukuda H, Shibata T, Fukushima T, Takatsuka Y, Ikeda S, Masuda M, Nagoshi H, Ueda R, Tamura K, Sano M, Momita S, Yamaguchi K, Kawano F, Hanada S, Tobinai K, Shimoyama M, Hotta T, Tomonaga M; Japan Clinical Oncology Group Study JCOG9801. VCAP-AMP-VECP compared with biweekly CHOP for adult T-cell leukemia-lymphoma: Japan Clinical Oncology Group Study JCOG9801. J Clin Oncol. 2007 Dec 1;25(34):5458-64. Epub 2007 Oct 29. [http://jco.ascopubs.org/content/25/34/5458.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/17968021 PubMed] | # Tsukasaki K, Utsunomiya A, Fukuda H, Shibata T, Fukushima T, Takatsuka Y, Ikeda S, Masuda M, Nagoshi H, Ueda R, Tamura K, Sano M, Momita S, Yamaguchi K, Kawano F, Hanada S, Tobinai K, Shimoyama M, Hotta T, Tomonaga M; Japan Clinical Oncology Group Study JCOG9801. VCAP-AMP-VECP compared with biweekly CHOP for adult T-cell leukemia-lymphoma: Japan Clinical Oncology Group Study JCOG9801. J Clin Oncol. 2007 Dec 1;25(34):5458-64. Epub 2007 Oct 29. [http://jco.ascopubs.org/content/25/34/5458.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/17968021 PubMed] | ||
| − | # Ishida T, Jo T, Takemoto S, Suzushima H, Uozumi K, Yamamoto K, Uike N, Saburi Y, Nosaka K, Utsunomiya A, Tobinai K, Fujiwara H, Ishitsuka K, Yoshida S, Taira N, Moriuchi Y, Imada K, Miyamoto T, Akinaga S, Tomonaga M, Ueda R. Dose-intensified chemotherapy alone or in combination with mogamulizumab in newly diagnosed aggressive adult T-cell leukaemia-lymphoma: a randomized phase II study. Br J Haematol. 2015 Jun;169(5):672-82. Epub 2015 Mar 2. [http://onlinelibrary.wiley.com/doi/10.1111/bjh.13338/full link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/25733162 PubMed] | + | # Ishida T, Jo T, Takemoto S, Suzushima H, Uozumi K, Yamamoto K, Uike N, Saburi Y, Nosaka K, Utsunomiya A, Tobinai K, Fujiwara H, Ishitsuka K, Yoshida S, Taira N, Moriuchi Y, Imada K, Miyamoto T, Akinaga S, Tomonaga M, Ueda R. Dose-intensified chemotherapy alone or in combination with mogamulizumab in newly diagnosed aggressive adult T-cell leukaemia-lymphoma: a randomized phase II study. Br J Haematol. 2015 Jun;169(5):672-82. Epub 2015 Mar 2. [http://onlinelibrary.wiley.com/doi/10.1111/bjh.13338/full link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5024033/ link to PMC article] [https://www.ncbi.nlm.nih.gov/pubmed/25733162 PubMed] |
=Relapsed/Refractory= | =Relapsed/Refractory= | ||
| Line 154: | Line 154: | ||
|[[Levels_of_Evidence#Evidence|'''Evidence''']] | |[[Levels_of_Evidence#Evidence|'''Evidence''']] | ||
|- | |- | ||
| − | |[ | + | |[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5215752/ Sharma et al. 2016] |
|style="background-color:#eeee00"|Phase II | |style="background-color:#eeee00"|Phase II | ||
|- | |- | ||
| Line 165: | Line 165: | ||
===References=== | ===References=== | ||
<!-- Presented in abstract form at the 50th Annual Meeting of the American Society of Hematology, San Francisco, CA, December 6–9, 2008. --> | <!-- Presented in abstract form at the 50th Annual Meeting of the American Society of Hematology, San Francisco, CA, December 6–9, 2008. --> | ||
| − | # Sharma K, Janik JE, O'Mahony D, Stewart D, Pittaluga S, Stetler-Stevenson M, Jaffe ES, Raffeld M, Fleisher TA, Lee CC, Steinberg SM, Waldmann TA, Morris JC. Phase II Study of Alemtuzumab (CAMPATH-1) in Patients with HTLV-1-Associated Adult T-cell Leukemia/lymphoma. Clin Cancer Res. 2017 Jan 1;23(1):35-42. Epub 2016 Aug 2. [http://clincancerres.aacrjournals.org/content/23/1/35.long link to original article] '''contain protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/27486175 PubMed] | + | # Sharma K, Janik JE, O'Mahony D, Stewart D, Pittaluga S, Stetler-Stevenson M, Jaffe ES, Raffeld M, Fleisher TA, Lee CC, Steinberg SM, Waldmann TA, Morris JC. Phase II Study of Alemtuzumab (CAMPATH-1) in Patients with HTLV-1-Associated Adult T-cell Leukemia/lymphoma. Clin Cancer Res. 2017 Jan 1;23(1):35-42. Epub 2016 Aug 2. [http://clincancerres.aacrjournals.org/content/23/1/35.long link to original article] '''contain protocol''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5215752/ link to PMC article] [https://www.ncbi.nlm.nih.gov/pubmed/27486175 PubMed] |
==Lenalidomide (Revlimid) {{#subobject:b2b90e|Regimen=1}}== | ==Lenalidomide (Revlimid) {{#subobject:b2b90e|Regimen=1}}== | ||
Revision as of 16:22, 26 July 2017
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Is there a regimen missing from this list? Would you like to share a different dosage/schedule or an additional reference for a regimen? Have you noticed an error? Do you have an idea that will help the site grow to better meet your needs and the needs of many others? You are invited to contribute to the site.
5 regimens on this page
5 variants on this page
|
Guidelines
NCCN
Untreated
CHOP-14
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CHOP: Cyclophosphamide, Hydroxydaunorubicin (Doxorubicin), Oncovin (Vincristine), Prednisone
Synonyms: CHOP-DI, I-CHOP
Structured Concept: none
Regimen
| Study | Evidence | Comparator | Efficacy |
| Tsukasaki et al. 2007 (JCOG 9801) | Phase III | mLSG15 | Seems to have inferior CR rate |
Chemotherapy
- Cyclophosphamide (Cytoxan) 750 mg/m2 IV once on day 1
- Doxorubicin (Adriamycin) 50 mg/m2 IV once on day 1
- Vincristine (Oncovin) 1.4 mg/m2 (max dose 2 mg) IV once on day 1
- Prednisone (Sterapred) 100 mg PO once per day on days 1 to 5
Supportive medications
- Filgrastim (Neupogen) given once ANC decreased to less than 1000/uL and continued once per day until count increased to greater than 5000/uL
14-day cycle for 8 cycles
Intrathecal component
Intrathecal triple-therapy was given during recovery phase of cycles 1, 3, and 5 after platelet count was greater than 70 × 109/L.
- Cytarabine (Cytosar) 40 mg IT
- Methotrexate (MTX) 15 mg IT
- Prednisone (Sterapred) 10 mg IT
3 doses, total
References
- Tsukasaki K, Utsunomiya A, Fukuda H, Shibata T, Fukushima T, Takatsuka Y, Ikeda S, Masuda M, Nagoshi H, Ueda R, Tamura K, Sano M, Momita S, Yamaguchi K, Kawano F, Hanada S, Tobinai K, Shimoyama M, Hotta T, Tomonaga M; Japan Clinical Oncology Group Study JCOG9801. VCAP-AMP-VECP compared with biweekly CHOP for adult T-cell leukemia-lymphoma: Japan Clinical Oncology Group Study JCOG9801. J Clin Oncol. 2007 Dec 1;25(34):5458-64. Epub 2007 Oct 29. link to original article contains verified protocol PubMed
LSG15
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Regimen
| Study | Evidence |
| Yamada et al. 2001 (JCOG 9303) | Phase II |
Ranimustine is not available in the United States and is approved only in Japan. This regimen was notable for excess CNS relapses and was subsequently replaced by mLSG15.
Chemotherapy
- Vincristine (Oncovin) 1 mg/m2 (maximum dose = 2 mg) IV once on day 1
- Cyclophosphamide (Cytoxan) 350 mg/m2 IV once on day 1
- Doxorubicin (Adriamycin) 40 mg/m2 IV once on day 1, then 30 mg/m2 IV once on day 8
- Prednisone (Sterapred) 40 mg/m2 PO once per day on days 1, 8, 15 to 17
- Ranimustine (Cymerin) 60 mg/m2 IV once on day 8
- Vindesine (Eldisine) 2.4 mg/m2 IV once on day 15
- Etoposide (Vepesid) 100 mg/m2 IV once per day on days 15 to 17
- Carboplatin (Paraplatin) 250 mg/m2 IV once on day 15
28-day cycle for 7 cycles
References
- Yamada Y, Tomonaga M, Fukuda H, Hanada S, Utsunomiya A, Tara M, Sano M, Ikeda S, Takatsuki K, Kozuru M, Araki K, Kawano F, Niimi M, Tobinai K, Hotta T, Shimoyama M. A new G-CSF-supported combination chemotherapy, LSG15, for adult T-cell leukaemia-lymphoma: Japan Clinical Oncology Group Study 9303. Br J Haematol. 2001 May;113(2):375-82. link to original article PubMed
mLSG15
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Regimen
| Study | Evidence | Comparator | Efficacy |
| Tsukasaki et al. 2007 (JCOG 9801) | Phase III | CHOP-14 | Seems to have superior CR rate |
| Ishida et al. 2015 | Randomized Phase II | mLSG15 & mogamulizumab | Seems not superior |
Ranimustine is not available in the United States and is approved only in Japan.
Chemotherapy
- Vincristine (Oncovin) 1 mg/m2 (maximum dose = 2 mg) IV once on day 1
- Cyclophosphamide (Cytoxan) 350 mg/m2 IV once on day 1
- Doxorubicin (Adriamycin) 40 mg/m2 IV once on day 1, then 30 mg/m2 IV once on day 8
- Prednisone (Sterapred) 40 mg/m2 PO once per day on days 1, 8, 15 to 17
- Ranimustine (Cymerin) 60 mg/m2 IV once on day 8
- Vindesine (Eldisine) 2.4 mg/m2 IV once on day 15
- Etoposide (Vepesid) 100 mg/m2 IV once per day on days 15 to 17
- Carboplatin (Paraplatin) 250 mg/m2 IV once on day 15
28-day cycle for 6 cycles
CNS prophylaxis
- Cytarabine (Cytosar) 40 mg mixed with Methotrexate (MTX) 15 mg and Prednisone (Sterapred) 10 mg IT
Given after cycles 1, 3, and 5 after platelets greater than 70 × 109/L and within 2 days before the next cycle
References
- Tsukasaki K, Utsunomiya A, Fukuda H, Shibata T, Fukushima T, Takatsuka Y, Ikeda S, Masuda M, Nagoshi H, Ueda R, Tamura K, Sano M, Momita S, Yamaguchi K, Kawano F, Hanada S, Tobinai K, Shimoyama M, Hotta T, Tomonaga M; Japan Clinical Oncology Group Study JCOG9801. VCAP-AMP-VECP compared with biweekly CHOP for adult T-cell leukemia-lymphoma: Japan Clinical Oncology Group Study JCOG9801. J Clin Oncol. 2007 Dec 1;25(34):5458-64. Epub 2007 Oct 29. link to original article contains verified protocol PubMed
- Ishida T, Jo T, Takemoto S, Suzushima H, Uozumi K, Yamamoto K, Uike N, Saburi Y, Nosaka K, Utsunomiya A, Tobinai K, Fujiwara H, Ishitsuka K, Yoshida S, Taira N, Moriuchi Y, Imada K, Miyamoto T, Akinaga S, Tomonaga M, Ueda R. Dose-intensified chemotherapy alone or in combination with mogamulizumab in newly diagnosed aggressive adult T-cell leukaemia-lymphoma: a randomized phase II study. Br J Haematol. 2015 Jun;169(5):672-82. Epub 2015 Mar 2. link to original article link to PMC article PubMed
Relapsed/Refractory
Alemtuzumab (Campath)
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Regimen
| Study | Evidence |
| Sharma et al. 2016 | Phase II |
Chemotherapy
- Alemtuzumab (Campath) 30 mg IV TIW (three times per week)
Up to 12-week course
References
- Sharma K, Janik JE, O'Mahony D, Stewart D, Pittaluga S, Stetler-Stevenson M, Jaffe ES, Raffeld M, Fleisher TA, Lee CC, Steinberg SM, Waldmann TA, Morris JC. Phase II Study of Alemtuzumab (CAMPATH-1) in Patients with HTLV-1-Associated Adult T-cell Leukemia/lymphoma. Clin Cancer Res. 2017 Jan 1;23(1):35-42. Epub 2016 Aug 2. link to original article contain protocol link to PMC article PubMed
Lenalidomide (Revlimid)
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Regimen
| Study | Evidence |
| Ishida et al. 2016 (ATLL-002) | Phase II |
Chemotherapy
- Lenalidomide (Revlimid) 25 mg PO once per day
Continued until progression
References
- Ishida T, Fujiwara H, Nosaka K, Taira N, Abe Y, Imaizumi Y, Moriuchi Y, Jo T, Ishizawa K, Tobinai K, Tsukasaki K, Ito S, Yoshimitsu M, Otsuka M, Ogura M, Midorikawa S, Ruiz W, Ohtsu T. Multicenter Phase II Study of Lenalidomide in Relapsed or Recurrent Adult T-Cell Leukemia/Lymphoma: ATLL-002. J Clin Oncol. 2016 Dec;34(34):4086-4093. link to original article PubMed