Difference between revisions of "T-cell lymphoma"

From HemOnc.org - A Hematology Oncology Wiki
Jump to navigation Jump to search
m (Text replacement - "[[NK/T-cell lymphoma" to "[[NK- and T-cell lymphoma")
 
(7 intermediate revisions by 2 users not shown)
Line 1: Line 1:
−
'''Use of this site is subject to you reading and agreeing with the terms set forth in the [[HemOnc.org_-_A_Hematology_Oncology_Wiki:General_disclaimer|disclaimer]].'''
+
='''T-cell lymphoma regimens have been moved to their histology-specific subtype pages. Please use the links below and/or update your bookmarks.'''=
  
−
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 [[How_to_contribute|invited to contribute to the site]].
+
==[[Anaplastic large cell lymphoma|Anaplastic large cell lymphoma (ALCL)]]==
  
−
{{TOC limit|limit=4}}
+
==[[Cutaneous T-cell lymphoma|Cutaneous T-cell lymphoma (CTCL)]]==
  
−
=Anaplastic large-cell lymphoma (ALCL)=
+
==[[Extranodal NK- and T-cell lymphoma, nasal type]]==
  
−
==Relapsed/refractory==
+
==[[NK- and T-cell lymphoma]]==
  
−
===Brentuximab vedotin (Adcetris)===
+
==[[Peripheral T-cell lymphoma|Peripheral T-cell Lymphoma (PTCL)]]==
  
−
====Regimen, Pro et al. 2012====
+
[[Category:Obsolete pages]]
−
<span
 
−
style="background:#EEEE00;
 
−
padding:3px 6px 3px 6px;
 
−
border-color:black;
 
−
border-width:2px;
 
−
border-style:solid;">Phase II</span>
 
−
 
 
−
*[[Brentuximab vedotin (Adcetris)]] 1.8 mg/kg IV over 30 minutes on day 1
 
−
 
 
−
'''3-week cycles up to 16 infusions'''
 
−
 
 
−
====References====
 
−
# Pro B, Advani R, Brice P, Bartlett NL, Rosenblatt JD, Illidge T, Matous J, Ramchandren R, Fanale M, Connors JM, Yang Y, Sievers EL, Kennedy DA, Shustov A. Brentuximab vedotin (SGN-35) in patients with relapsed or refractory systemic anaplastic large-cell lymphoma: results of a phase II study. J Clin Oncol. 2012 Jun 20;30(18):2190-6. Epub 2012 May 21. [http://jco.ascopubs.org/content/30/18/2190.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/22614995 PubMed]
 
−
 
 
−
=[[Cutaneous T-cell lymphoma|Cutaneous T-cell lymphoma (CTCL)]]=
 
−
 
 
−
=Extranodal NK/T-cell lymphoma (ENKTCL), nasal type=
 
−
 
 
−
==Untreated==
 
−
 
 
−
===Cisplatin & Concurrent RT -> VIPD===
 
−
VIPD: '''<u>V</u>'''P-16, '''<u>I</u>'''fosfamide, '''<u>P</u>'''latinol, '''<u>D</u>'''examethasone
 
−
 
 
−
====Regimen, Kim et al. 2009====
 
−
<span
 
−
style="background:#EEEE00;
 
−
padding:3px 6px 3px 6px;
 
−
border-color:black;
 
−
border-width:2px;
 
−
border-style:solid;">Phase II</span>
 
−
 
 
−
=====Chemoradiation=====
 
−
*[[Cisplatin (Platinol)]] 30 mg/m2 IV once per week
 
−
*Concurrent radiation therapy to the primary tumor, 1.8 to 2 Gy fractions (median total dose: 40 Gy), given 5 times per week.
 
−
 
 
−
=====Chemotherapy=====
 
−
''Chemotherapy starts 3 to 5 weeks after the last dose of cisplatin''
 
−
*[[Etoposide (Vepesid)]] 100 mg/m2 IV over 90 minutes once per day on days 1 to 3
 
−
*[[Ifosfamide (Ifex)]] 1200 mg/m2 IV over 1 hour once per day on days 1 to 3
 
−
*[[Cisplatin (Platinol)]] 33 mg/m2 IV over 1 hour once per day on days 1 to 3
 
−
*[[Dexamethasone (Decadron)]] 40 mg PO/IV once per day on days 1 to 4
 
−
 
 
−
Supportive medications:
 
−
*[[Mesna (Mesnex)]] 240 mg/m2 IV over 15 minutes once per day on days 1 to 3
 
−
*[[Filgrastim (Neupogen)|G-CSF]] given for grade 3 or 4 neutropenia
 
−
 
 
−
'''21-day cycles x up to 3 cycles'''
 
−
 
 
−
====References====
 
−
# Kim SJ, Kim K, Kim BS, Kim CY, Suh C, Huh J, Lee SW, Kim JS, Cho J, Lee GW, Kang KM, Eom HS, Pyo HR, Ahn YC, Ko YH, Kim WS. Phase II trial of concurrent radiation and weekly cisplatin followed by VIPD chemotherapy in newly diagnosed,  stage IE to IIE, nasal, extranodal NK/T-Cell Lymphoma: Consortium for Improving Survival of Lymphoma study. J Clin Oncol. 2009 Dec 10;27(35):6027-32. [http://jco.ascopubs.org/content/27/35/6027.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/19884539 PubMed]
 
−
 
 
−
===DeVIC & Concurrent RT===
 
−
DeVIC: '''<u>De</u>'''xamethasone, '''<u>V</u>'''P-16, '''<u>I</u>'''fosfamide, '''<u>C</u>'''arboplatin
 
−
 
 
−
====Regimen, Yamaguchi et al. 2009 (JCOG0211)====
 
−
 
 
−
<span
 
−
style="background:#EEEE00;
 
−
padding:3px 6px 3px 6px;
 
−
border-color:black;
 
−
border-width:2px;
 
−
border-style:solid;">Phase II</span>
 
−
 
 
−
=====Dose Level I=====
 
−
*[[Dexamethasone (Decadron)]] 40 mg IV once per day on days 1 to 3
 
−
*[[Etoposide (Vepesid)]] 67 mg/m2 IV over 2 hours once per day on days 1 to 3
 
−
*[[Ifosfamide (Ifex)]] 1000 mg/m2 IV over 3 hours once per day on days 1 to 3
 
−
*[[Carboplatin (Paraplatin)]] 200 mg/m2 IV over 30 minutes once on day 1
 
−
 
 
−
=====Dose Level II=====
 
−
*[[Dexamethasone (Decadron)]] 40 mg IV once per day on days 1 to 3
 
−
*[[Etoposide (Vepesid)]] 100 mg/m2 IV over 2 hours once per day on days 1 to 3
 
−
*[[Ifosfamide (Ifex)]] 1500 mg/m2 IV over 3 hours once per day on days 1 to 3
 
−
*[[Carboplatin (Paraplatin)]] 300 mg/m2 IV over 30 minutes once on day 1
 
−
 
 
−
Supportive medications:
 
−
*[[Filgrastim (Neupogen)]] (dose/route/schedule not specified) started for leukocyte count <2,000/μL or ANC <1,000/μL; discontinued if leukocyte count >5,000/μL.
 
−
 
 
−
'''21-day cycles x 3 cycles'''
 
−
 
 
−
=====Concurrent radiation therapy=====
 
−
''Started simultaneously with the beginning of cycle 1 of chemotherapy''
 
−
*Stage IE disease: Concurrent radiation therapy, 2 Gy fractions x 25 fractions (total dose: 50 Gy) over 5 weeks
 
−
*Stage IIE disease: Concurrent radiation therapy, 1.8 Gy fractions x 28 fractions (total dose: 50.4 Gy) over 6 weeks
 
−
 
 
−
====References====
 
−
# Yamaguchi M, Tobinai K, Oguchi M, Ishizuka N, Kobayashi Y, Isobe Y, Ishizawa K, Maseki N, Itoh K, Usui N, Wasada I, Kinoshita T, Ohshima K, Matsuno Y, Terauchi T, Nawano S, Ishikura S, Kagami Y, Hotta T, Oshimi K. Phase I/II study of concurrent chemoradiotherapy for localized nasal natural killer/T-cell lymphoma: Japan Clinical Oncology Group Study JCOG0211. J Clin Oncol. 2009 Nov 20;27(33):5594-600. [http://jco.ascopubs.org/content/27/33/5594.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/19805668 PubMed]
 
−
# '''Update:''' Yamaguchi M, Tobinai K, Oguchi M, Ishizuka N, Kobayashi Y, Isobe Y, Ishizawa K, Maseki N, Itoh K, Usui N, Wasada I, Kinoshita T, Hotta T, Tsukasaki K, Oshimi K. Concurrent chemoradiotherapy for localized nasal natural killer/T-cell lymphoma: an updated analysis of the Japan clinical oncology group study JCOG0211. J Clin Oncol. 2012 Nov 10;30(32):4044-6. Epub 2012 Oct 8. [http://jco.ascopubs.org/content/30/32/4044.2.long link to original article] [http://www.ncbi.nlm.nih.gov/pubmed/23045573 PubMed]
 
−
 
 
−
===GELOX===
 
−
GELOX: '''<u>G</u>'''emcitabine, '''<u>L</u>'''-asparaginase, '''<u>O</u>'''xaliplatin
 
−
 
 
−
====Regimen====
 
−
 
 
−
<span
 
−
style="background:#EEEE00;
 
−
padding:3px 6px 3px 6px;
 
−
border-color:black;
 
−
border-width:2px;
 
−
border-style:solid;">Phase II</span>
 
−
 
 
−
*[[Gemcitabine (Gemzar)]] 1000 mg/m2 IV once per day on days 1 & 8
 
−
*[[Asparaginase (Elspar)]] 6000 units/m2 IV once per day on days 1 to 7
 
−
*[[Oxaliplatin (Eloxatin)]] 130 mg/m2 once on day 1
 
−
 
 
−
'''3-weeks cycles for at least 2 cycles, then:'''
 
−
 
 
−
*Involved field radiation to 56 grays (Gy) in 28 fractions, 5 fractions per week
 
−
 
 
−
'''Followed by more chemotherapy within one week of radiation completion, up to 6 total cycles'''
 
−
 
 
−
====References====
 
−
# Wang L, Wang ZH, Chen XQ, Li YJ, Wang KF, Xia YF, Xia ZJ. First-line combination of gemcitabine, oxaliplatin, and L-asparaginase (GELOX) followed by involved-field radiation therapy for patients with stage IE/IIE extranodal natural killer/T-cell lymphoma. Cancer. 2013 Jan 15;119(2):348-55. Epub 2012 Jul 18. [http://onlinelibrary.wiley.com/doi/10.1002/cncr.27752/full link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/22811078 PubMed]
 
−
 
 
−
===LVP "Sandwich"===
 
−
LVP: '''<u>L</u>'''-asparaginase, '''<u>V</u>'''incristine, '''<u>P</u>'''rednisolone
 
−
 
 
−
====Regimen====
 
−
 
 
−
<span
 
−
style="background:#EEEE00;
 
−
padding:3px 6px 3px 6px;
 
−
border-color:black;
 
−
border-width:2px;
 
−
border-style:solid;">Phase II</span>
 
−
 
 
−
*[[Asparaginase (Elspar)]] 6000 units/m2 IV once per day on days 1 to 5
 
−
*[[Vincristine (Oncovin)]] 1.4 mg/m2 IV once on day 1
 
−
*[[Prednisolone (Millipred)]] 100 mg PO once per day on days to 5
 
−
 
 
−
'''3-week cycles x 2 cycles, then'''
 
−
 
 
−
*Radiation to the nasal cavity and surrounding sinuses, 56 Gy in 28 fractions, once per day, five days per week
 
−
 
 
−
'''Resume chemotherapy one week after completion of radiation, up to 6 total cycles'''
 
−
 
 
−
====References====
 
−
# Jiang M, Zhang H, Jiang Y, Yang Q, Xie L, Liu W, Zhang W, Ji X, Li P, Chen N, Zhao S, Wang F, Zou L. Phase 2 trial of "sandwich" L-asparaginase, vincristine, and prednisone chemotherapy with radiotherapy in newly diagnosed, stage IE to IIE, nasal type, extranodal natural killer/T-cell lymphoma. Cancer. 2012 Jul 1;118(13):3294-301. Epub 2011 Dec 2. [http://onlinelibrary.wiley.com/doi/10.1002/cncr.26629/full link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/22139825 PubMed]
 
−
 
 
−
===SMILE===
 
−
SMILE: '''<u>S</u>'''teroid (dexamethasone), '''<u>M</u>'''ethotrexate, '''<u>I</u>'''fosfamide, '''<u>L</u>'''-asparaginase, '''<u>E</u>'''toposide
 
−
 
 
−
====Regimen====
 
−
 
 
−
<span
 
−
style="background:#EEEE00;
 
−
padding:3px 6px 3px 6px;
 
−
border-color:black;
 
−
border-width:2px;
 
−
border-style:solid;">Phase II</span>
 
−
 
 
−
*[[Dexamethasone (Decadron)]] 40 mg PO/IV once per day on days 2 to 4
 
−
*[[Methotrexate (MTX)]] 2000 mg/m2 IV over 6 hours once on day 1
 
−
*[[Ifosfamide (Ifex)]] 1500 mg/m2 IV once per day on days 2 to 4
 
−
*[[Asparaginase (Elspar)]] 6000 units/m2 IV once per day on days 8, 10, 12, 14, 16, 18, 20
 
−
*[[Etoposide (Vepesid)]] 100 mg/m2 IV once per day on days 2 to 4
 
−
 
 
−
Supportive medications:
 
−
*[[Folinic acid (Leucovorin)]] 15 mg PO/IV Q6H x 4 doses per day on days 2 to 4, beginning 30 hours after completion of [[Methotrexate (MTX)]]
 
−
*[[Mesna (Mesnex)]] 300 mg/m2 IV three times per day on days 2 to 4; first dose given together with [[Ifosfamide (Ifex)]], second dose given at 4 hours after start of [[Ifosfamide (Ifex)]], and third dose given 8 hours after start of [[Ifosfamide (Ifex)]]
 
−
*[[Filgrastim (Neupogen)]] (dose not specified) SC/IV once per day starting on day 6, given until WBC >5 x 10<sup>9</sup>/L
 
−
*[[Trimethoprim/Sulfamethoxazole (Bactrim DS)]] prophylaxis recommended
 
−
 
 
−
'''28-day cycles x 2 cycles'''; after 2 cycles, patients could receive additional treatment with SMILE and/or other chemotherapy, with or without autologous/allogeneic stem cell transplant.
 
−
 
 
−
====References====
 
−
# Yamaguchi M, Suzuki R, Kwong YL, Kim WS, Hasegawa Y, Izutsu K, Suzumiya J, Okamura T, Nakamura S, Kawa K, Oshimi K. Phase I study of dexamethasone, methotrexate, ifosfamide, L-asparaginase, and etoposide (SMILE) chemotherapy for advanced-stage, relapsed or refractory extranodal natural killer (NK)/T-cell lymphoma and leukemia. Cancer Sci. 2008 May;99(5):1016-20. Epub 2008 Feb 19. [http://onlinelibrary.wiley.com/doi/10.1111/j.1349-7006.2008.00768.x/full link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/18294294 PubMed] content property of [http://hemonc.org HemOnc.org]
 
−
# Yamaguchi M, Kwong YL, Kim WS, Maeda Y, Hashimoto C, Suh C, Izutsu K, Ishida F, Isobe Y, Sueoka E, Suzumiya J, Kodama T, Kimura H, Hyo R, Nakamura S, Oshimi K, Suzuki R. Phase II study of SMILE chemotherapy for newly diagnosed stage IV, relapsed, or refractory extranodal natural killer (NK)/T-cell lymphoma, nasal type: the NK-Cell Tumor Study Group study. J Clin Oncol. 2011 Nov 20;29(33):4410-6. Epub 2011 Oct 11. [http://jco.ascopubs.org/content/29/33/4410.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/21990393 PubMed]
 
−
 
 
−
==Relapsed/refractory==
 
−
 
 
−
===AspaMetDex===
 
−
AspaMetDex: '''<u>Aspa</u>'''raginase, '''<u>Met</u>'''hotrexate, '''<u>Dex</u>'''amethasone
 
−
 
 
−
====Regimen, Jaccard et al. 2011====
 
−
<span
 
−
style="background:#EEEE00;
 
−
padding:3px 6px 3px 6px;
 
−
border-color:black;
 
−
border-width:2px;
 
−
border-style:solid;">Phase II</span>
 
−
 
 
−
*[[Asparaginase (Elspar)]] 6000 units/m2 IM once per day on days 2, 4, 6, 8
 
−
**Patients who had allergies to Asparaginase (Elspar) received [[Asparaginase Erwinia chrysanthemi (Erwinaze)]] 20,000 units/m2 IM once per day on days 2, 4, 6, 8
 
−
*[[Methotrexate (MTX)]] 3000 mg/m2 (route not specified) once on day 1
 
−
**Patients >70 years old received [[Methotrexate (MTX)]] 2000 mg/m2 (route not specified) once on day 1
 
−
*[[Dexamethasone (Decadron)]] 40 mg PO once per day on days 1 to 4
 
−
**Patients >70 years old received [[Dexamethasone (Decadron)]] 20 mg PO once per day on days 1 to 4
 
−
 
 
−
Supportive medications:
 
−
*[[Trimethoprim/Sulfamethoxazole (Bactrim DS)]] (dose/route/schedule not specified) prophylaxis, discontinued during [[Methotrexate (MTX)]] administration
 
−
*[[Valacyclovir (Valtrex)]] (dose/route/schedule not specified) prophylaxis
 
−
*For [[Methotrexate (MTX)]]: alkaline hydration and [[Folinic acid (Leucovorin)]] rescue (dose/route/schedule not specified)
 
−
 
 
−
'''21-day cycles x 3 cycles'''; see Jaccard et al. 2011 for details about further treatment
 
−
 
 
−
====References====
 
−
# Jaccard A, Gachard N, Marin B, Rogez S, Audrain M, Suarez F, Tilly H, Morschhauser F, Thieblemont C, Ysebaert L, Devidas A, Petit B, de Leval L, Gaulard P, Feuillard J, Bordessoule D, Hermine O; GELA and GOELAMS Intergroup. Efficacy of L-asparaginase with methotrexate and dexamethasone (AspaMetDex regimen) in patients with refractory or relapsing extranodal NK/T-cell lymphoma,  a phase 2 study. Blood. 2011 Feb 10;117(6):1834-9. [http://bloodjournal.hematologylibrary.org/content/117/6/1834.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/21123825 PubMed]
 
−
 
 
−
===LVP===
 
−
LVP: '''<u>L</u>'''-asparaginase, '''<u>V</u>'''incristine, '''<u>P</u>'''rednisolone
 
−
 
 
−
====Regimen====
 
−
<span
 
−
style="background:#ff0000;
 
−
padding:3px 6px 3px 6px;
 
−
border-color:black;
 
−
border-width:2px;
 
−
border-style:solid;">Phase II, <20 patients reported</span>
 
−
 
 
−
''Regimen details are from a review article; original article is not available through PubMed''
 
−
 
 
−
*[[Asparaginase (Elspar)]] 6000 units/m2 IV once per day on days 1 to 5
 
−
*[[Vincristine (Oncovin)]] 1.4 mg/m2 IV once on day 1
 
−
*[[Prednisolone (Millipred)]] 100 mg PO once per day on days to 5
 
−
 
 
−
====References====
 
−
# Yong W, Zheng W, Zhang Y, Zhu J, Wei Y, Zhu D, Li J. L-asparaginase-based regimen in the treatment of refractory midline nasal/nasal-type T/NK-cell lymphoma. Int J Hematol. 2003 Aug;78(2):163-7. [http://www.ncbi.nlm.nih.gov/pubmed/12953813 PubMed]
 
−
 
 
−
===SMILE===
 
−
SMILE: '''<u>S</u>'''teroid (dexamethasone), '''<u>M</u>'''ethotrexate, '''<u>I</u>'''fosfamide, '''<u>L</u>'''-asparaginase, '''<u>E</u>'''toposide
 
−
 
 
−
====Regimen====
 
−
<span
 
−
style="background:#EEEE00;
 
−
padding:3px 6px 3px 6px;
 
−
border-color:black;
 
−
border-width:2px;
 
−
border-style:solid;">Phase II</span>
 
−
 
 
−
*[[Dexamethasone (Decadron)]] 40 mg PO/IV once per day on days 2 to 4
 
−
*[[Methotrexate (MTX)]] 2000 mg/m2 IV over 6 hours once on day 1
 
−
*[[Ifosfamide (Ifex)]] 1500 mg/m2 IV once per day on days 2 to 4
 
−
*[[Asparaginase (Elspar)]] 6000 units/m2 IV once per day on days 8, 10, 12, 14, 16, 18, 20
 
−
*[[Etoposide (Vepesid)]] 100 mg/m2 IV once per day on days 2 to 4
 
−
 
 
−
Supportive medications:
 
−
*[[Folinic acid (Leucovorin)]] 15 mg PO/IV Q6H x 4 doses per day on days 2 to 4, beginning 30 hours after completion of [[Methotrexate (MTX)]]
 
−
*[[Mesna (Mesnex)]] 300 mg/m2 IV three times per day on days 2 to 4; first dose given together with [[Ifosfamide (Ifex)]], second dose given at 4 hours after start of [[Ifosfamide (Ifex)]], and third dose given 8 hours after start of [[Ifosfamide (Ifex)]]
 
−
*[[Filgrastim (Neupogen)]] (dose not specified) SC/IV once per day starting on day 6, given until WBC >5 x 10<sup>9</sup>/L
 
−
*[[Trimethoprim/Sulfamethoxazole (Bactrim DS)]] prophylaxis recommended
 
−
 
 
−
'''28-day cycles x 2 cycles'''; after 2 cycles, patients could receive additional treatment with SMILE and/or other chemotherapy, with or without autologous/allogeneic stem cell transplant.
 
−
 
 
−
====References====
 
−
# Yamaguchi M, Suzuki R, Kwong YL, Kim WS, Hasegawa Y, Izutsu K, Suzumiya J, Okamura T, Nakamura S, Kawa K, Oshimi K. Phase I study of dexamethasone, methotrexate, ifosfamide, L-asparaginase, and etoposide (SMILE) chemotherapy for advanced-stage, relapsed or refractory extranodal natural killer (NK)/T-cell lymphoma and leukemia. Cancer Sci. 2008 May;99(5):1016-20. Epub 2008 Feb 19. [http://onlinelibrary.wiley.com/doi/10.1111/j.1349-7006.2008.00768.x/full link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/18294294 PubMed] content property of [http://hemonc.org HemOnc.org]
 
−
# Yamaguchi M, Kwong YL, Kim WS, Maeda Y, Hashimoto C, Suh C, Izutsu K, Ishida F, Isobe Y, Sueoka E, Suzumiya J, Kodama T, Kimura H, Hyo R, Nakamura S, Oshimi K, Suzuki R. Phase II study of SMILE chemotherapy for newly diagnosed stage IV, relapsed, or refractory extranodal natural killer (NK)/T-cell lymphoma, nasal type: the NK-Cell Tumor Study Group study. J Clin Oncol. 2011 Nov 20;29(33):4410-6. Epub 2011 Oct 11. [http://jco.ascopubs.org/content/29/33/4410.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/21990393 PubMed]
 
−
 
 
−
=NK/T-cell lymphoma=
 
−
 
 
−
==Untreated==
 
−
 
 
−
===SMILE===
 
−
SMILE: '''<u>S</u>'''teroid (dexamethasone), '''<u>M</u>'''ethotrexate, '''<u>I</u>'''fosfamide, '''<u>L</u>'''-asparaginase, '''<u>E</u>'''toposide
 
−
 
 
−
====Regimen====
 
−
<span
 
−
style="background:#EEEE00;
 
−
padding:3px 6px 3px 6px;
 
−
border-color:black;
 
−
border-width:2px;
 
−
border-style:solid;">Phase II</span>
 
−
 
 
−
*[[Dexamethasone (Decadron)]] 40 mg PO once per day on days 2 to 4
 
−
*[[Methotrexate (MTX)]] 2000 mg/m2 in 500 mL normal saline IV over 6 hours once on day 1
 
−
**Methotrexate levels checked at 24, 48, and 72 hours after methotrexate is given, or until methotrexate levels fall below toxic range.  Folinic acid should be continued until methotrexate levels are below toxic range.
 
−
*[[Ifosfamide (Ifex)]] 1500 mg/m2 in 1 liter normal saline IV over 6 hours once per day on days 2 to 4, given together with mesna
 
−
*[[Asparaginase (Elspar)]] 6000 units/m2 in 250 mL normal saline IV over 2 hours once per day on days 8, 10, 12, 14, 16, 18, 20
 
−
**Skin test done for asparaginase before each dose; [[Asparaginase Erwinia chrysanthemi (Erwinaze)]] used for patients who developed sensitivity to L-asparaginase from E. coli
 
−
*[[Etoposide (Vepesid)]] 100 mg/m2 in 500 mL normal saline IV over 2 hours once per day on days 2 to 4
 
−
 
 
−
Supportive medications:
 
−
*[[Folinic acid (Leucovorin)]] 45 mg PO Q6H x 4 doses per day on days 2 to 4 (or until serum methotrexate level is below the toxic range), starting 24 hours after completion of [[Methotrexate (MTX)]]
 
−
*[[Mesna (Mesnex)]] 900 mg/m2 IV over 6 hours once per day on days 2 to 4, given together with [[Ifosfamide (Ifex)]]
 
−
*Hydration with normal saline (no volume specified) Q8H x 1 day prior to [[Methotrexate (MTX)]]
 
−
*Patients told to drink at least 2 liters of fluid per day on days 1 to 4; target urine output of ≥3 liters per day on days 1 to 4
 
−
*[[Filgrastim (Neupogen)]] 300 mcg SC once per day, starting on day 6, given until ANC >1 x 10<sup>9</sup>/L
 
−
*[[Trimethoprim/Sulfamethoxazole (Bactrim DS)|Cotrimoxazole]] or [[Pentamidine (Nebupent)]] for PJP prophylaxis
 
−
*[[Famotidine (Pepcid)]] and potassium slow release tablets (no dose specified) "for [[Dexamethasone (Decadron)]]" on days 2 to 4
 
−
*Chlorpheniramine (note: was spelled in the protocol as "chlorphenarime") 10 mg PO once prior to [[Asparaginase (Elspar)]] infusions on days 8, 10, 12, 14, 16, 18, 20
 
−
*[[Hydrocortisone (Cortef)]] 100 mg IV once prior to [[Asparaginase (Elspar)]] infusions on days 8, 10, 12, 14, 16, 18, 20
 
−
 
 
−
'''up to 6 cycles given'''; paper and supplement did not specify the length of each cycle, but other SMILE regimens, e.g. Yamaguchi et al. 2011 above, describe 28-day cycles
 
−
 
 
−
====References====
 
−
# Yamaguchi M, Suzuki R, Kwong YL, Kim WS, Hasegawa Y, Izutsu K, Suzumiya J, Okamura T, Nakamura S, Kawa K, Oshimi K. Phase I study of dexamethasone, methotrexate, ifosfamide, L-asparaginase, and etoposide (SMILE) chemotherapy for advanced-stage, relapsed or refractory extranodal natural killer (NK)/T-cell lymphoma and leukemia. Cancer Sci. 2008 May;99(5):1016-20. Epub 2008 Feb 19. [http://onlinelibrary.wiley.com/doi/10.1111/j.1349-7006.2008.00768.x/full link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/18294294 PubMed] content property of [http://hemonc.org HemOnc.org]
 
−
# Kwong YL, Kim WS, Lim ST, Kim SJ, Tang T, Tse E, Leung AY, Chim CS. SMILE for natural killer/T-cell lymphoma: analysis of safety and efficacy from the Asia Lymphoma Study Group. Blood. 2012 Oct 11;120(15):2973-80. Epub 2012 Aug 23. [http://bloodjournal.hematologylibrary.org/content/120/15/2973.long link to original article] [http://bloodjournal.hematologylibrary.org/content/120/15/2973/suppl/DC1 supplemental materials] '''supplemental materials contain verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/22919026 PubMed]
 
−
 
 
−
==Relapsed/refractory==
 
−
 
 
−
===SMILE===
 
−
SMILE: '''<u>S</u>'''teroid (dexamethasone), '''<u>M</u>'''ethotrexate, '''<u>I</u>'''fosfamide, '''<u>L</u>'''-asparaginase, '''<u>E</u>'''toposide
 
−
 
 
−
====Regimen====
 
−
<span
 
−
style="background:#EEEE00;
 
−
padding:3px 6px 3px 6px;
 
−
border-color:black;
 
−
border-width:2px;
 
−
border-style:solid;">Phase II</span>
 
−
 
 
−
*[[Dexamethasone (Decadron)]] 40 mg PO once per day on days 2 to 4
 
−
*[[Methotrexate (MTX)]] 2000 mg/m2 in 500 mL normal saline IV over 6 hours once on day 1
 
−
**Methotrexate levels checked at 24, 48, and 72 hours after methotrexate is given, or until methotrexate levels fall below toxic range.  Folinic acid should be continued until methotrexate levels are below toxic range.
 
−
*[[Ifosfamide (Ifex)]] 1500 mg/m2 in 1 liter normal saline IV over 6 hours once per day on days 2 to 4, given together with mesna
 
−
*[[Asparaginase (Elspar)]] 6000 units/m2 in 250 mL normal saline IV over 2 hours once per day on days 8, 10, 12, 14, 16, 18, 20
 
−
**Skin test done for asparaginase before each dose; [[Asparaginase Erwinia chrysanthemi (Erwinaze)]] used for patients who developed sensitivity to L-asparaginase from E. coli
 
−
*[[Etoposide (Vepesid)]] 100 mg/m2 in 500 mL normal saline IV over 2 hours once per day on days 2 to 4
 
−
 
 
−
Supportive medications:
 
−
*[[Folinic acid (Leucovorin)]] 45 mg PO Q6H x 4 doses per day on days 2 to 4 (or until serum methotrexate level is below the toxic range), starting 24 hours after completion of [[Methotrexate (MTX)]]
 
−
*[[Mesna (Mesnex)]] 900 mg/m2 IV over 6 hours once per day on days 2 to 4, given together with [[Ifosfamide (Ifex)]]
 
−
*Hydration with normal saline (no volume specified) Q8H x 1 day prior to methotrexate
 
−
*Patients told to drink at least 2 liters of fluid per day on days 1 to 4; target urine output of ≥3 liters per day on days 1 to 4
 
−
*[[Filgrastim (Neupogen)]] 300 mcg SC once per day, starting on day 6, given until ANC >1 x 10<sup>9</sup>/L
 
−
*[[Trimethoprim/Sulfamethoxazole (Bactrim DS)|Cotrimoxazole]] or [[Pentamidine (Nebupent)]] for PJP prophylaxis
 
−
*[[Famotidine (Pepcid)]] and potassium slow release tablets (no dose specified) "for [[Dexamethasone (Decadron)]]" on days 2 to 4
 
−
*Chlorpheniramine (note: was spelled in the protocol as "chlorphenarime") 10 mg PO once prior to [[Asparaginase (Elspar)]] infusions on days 8, 10, 12, 14, 16, 18, 20
 
−
*[[Hydrocortisone (Cortef)]] 100 mg IV once prior to [[Asparaginase (Elspar)]] infusions on days 8, 10, 12, 14, 16, 18, 20
 
−
 
 
−
'''up to 6 cycles given'''; paper and supplement did not specify the length of each cycle, but other SMILE regimens, e.g. Yamaguchi et al. 2011 above, describe 28-day cycles
 
−
 
 
−
====References====
 
−
# Yamaguchi M, Suzuki R, Kwong YL, Kim WS, Hasegawa Y, Izutsu K, Suzumiya J, Okamura T, Nakamura S, Kawa K, Oshimi K. Phase I study of dexamethasone, methotrexate, ifosfamide, L-asparaginase, and etoposide (SMILE) chemotherapy for advanced-stage, relapsed or refractory extranodal natural killer (NK)/T-cell lymphoma and leukemia. Cancer Sci. 2008 May;99(5):1016-20. Epub 2008 Feb 19. [http://onlinelibrary.wiley.com/doi/10.1111/j.1349-7006.2008.00768.x/full link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/18294294 PubMed] content property of [http://hemonc.org HemOnc.org]
 
−
# Kwong YL, Kim WS, Lim ST, Kim SJ, Tang T, Tse E, Leung AY, Chim CS. SMILE for natural killer/T-cell lymphoma: analysis of safety and efficacy from the Asia Lymphoma Study Group. Blood. 2012 Oct 11;120(15):2973-80. Epub 2012 Aug 23. [http://bloodjournal.hematologylibrary.org/content/120/15/2973.long link to original article] [http://bloodjournal.hematologylibrary.org/content/120/15/2973/suppl/DC1 supplemental materials] '''supplemental materials contain verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/22919026 PubMed]
 
−
 
 
−
=[[Peripheral T-cell lymphoma|Peripheral T-cell Lymphoma (PTCL)]]=
 

Latest revision as of 16:50, 23 November 2019

T-cell lymphoma regimens have been moved to their histology-specific subtype pages. Please use the links below and/or update your bookmarks.

Anaplastic large cell lymphoma (ALCL)

Cutaneous T-cell lymphoma (CTCL)

Extranodal NK- and T-cell lymphoma, nasal type

NK- and T-cell lymphoma

Peripheral T-cell Lymphoma (PTCL)

Retrieved from "https://hemonc.org/w/index.php?title=T-cell_lymphoma&oldid=41091"