Difference between revisions of "T-cell lymphoma"

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'''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]].'''
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='''T-cell lymphoma regimens have been moved to their histology-specific subtype pages. Please use the links below and/or update your bookmarks.'''=
  
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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 [[How_to_contribute|invited to contribute to the site]].
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==[[Anaplastic large cell lymphoma|Anaplastic large cell lymphoma (ALCL)]]==
  
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{{TOC limit|limit=4}}
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==[[Cutaneous T-cell lymphoma|Cutaneous T-cell lymphoma (CTCL)]]==
  
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=[[Anaplastic large-cell lymphoma|Anaplastic large-cell lymphoma (ALCL)]]=
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==[[Extranodal NK- and T-cell lymphoma, nasal type]]==
  
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=[[Cutaneous T-cell lymphoma|Cutaneous T-cell lymphoma (CTCL)]]=
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==[[NK- and T-cell lymphoma]]==
  
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=[[Extranodal NK/T-cell lymphoma, nasal type]]=
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==[[Peripheral T-cell lymphoma|Peripheral T-cell Lymphoma (PTCL)]]==
  
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=NK/T-cell lymphoma=
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[[Category:Obsolete pages]]
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==Untreated==
 
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===SMILE===
 
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SMILE: '''<u>S</u>'''teroid (dexamethasone), '''<u>M</u>'''ethotrexate, '''<u>I</u>'''fosfamide, '''<u>L</u>'''-asparaginase, '''<u>E</u>'''toposide
 
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====Regimen====
 
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<span
 
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style="background:#EEEE00;
 
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padding:3px 6px 3px 6px;
 
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border-color:black;
 
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border-width:2px;
 
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border-style:solid;">Phase II</span>
 
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*[[Dexamethasone (Decadron)]] 40 mg PO once per day on days 2 to 4
 
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*[[Methotrexate (MTX)]] 2000 mg/m2 in 500 mL normal saline IV over 6 hours once on day 1
 
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**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.
 
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*[[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
 
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*[[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
 
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**Skin test done for asparaginase before each dose; [[Asparaginase Erwinia chrysanthemi (Erwinaze)]] used for patients who developed sensitivity to L-asparaginase from E. coli
 
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*[[Etoposide (Vepesid)]] 100 mg/m2 in 500 mL normal saline IV over 2 hours once per day on days 2 to 4
 
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Supportive medications:
 
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*[[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)]]
 
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*[[Mesna (Mesnex)]] 900 mg/m2 IV over 6 hours once per day on days 2 to 4, given together with [[Ifosfamide (Ifex)]]
 
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*Hydration with normal saline (no volume specified) Q8H x 1 day prior to [[Methotrexate (MTX)]]
 
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*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
 
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*[[Filgrastim (Neupogen)]] 300 mcg SC once per day, starting on day 6, given until ANC >1 x 10<sup>9</sup>/L
 
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*[[Trimethoprim/Sulfamethoxazole (Bactrim DS)|Cotrimoxazole]] or [[Pentamidine (Nebupent)]] for PJP prophylaxis
 
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*[[Famotidine (Pepcid)]] and potassium slow release tablets (no dose specified) "for [[Dexamethasone (Decadron)]]" on days 2 to 4
 
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*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
 
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*[[Hydrocortisone (Cortef)]] 100 mg IV once prior to [[Asparaginase (Elspar)]] infusions on days 8, 10, 12, 14, 16, 18, 20
 
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'''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
 
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====References====
 
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# 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]
 
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# 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]
 
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==Relapsed/refractory==
 
−
 
 
−
===SMILE===
 
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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]
 
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=[[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)

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