Revision as of 12:32, 29 October 2022

Back to Top

Section editor transclusions Are you looking for a regimen, but can't find it here? It is possible that we've moved it to the historical regimens page.

5 regimens on this page 5 variants on this page

Guidelines

"How I Treat"

2021: Cook & Phillips How I treat adult T-cell leukemia/lymphoma

NCCN

NCCN Guidelines - T-cell Lymphomas

Untreated

CHOP-14

CHOP-14: Cyclophosphamide, Hydroxydaunorubicin (Doxorubicin), Oncovin (Vincristine), Predniso(lo)ne every 14 days
CHOP-DI: Cyclophosphamide, Hydroxydaunorubicin (Doxorubicin), Oncovin (Vincristine), Predniso(lo)ne, Dose-Intense
I-CHOP: Intensive Cyclophosphamide, Hydroxydaunorubicin (Doxorubicin), Oncovin (Vincristine), Predniso(lo)ne

Regimen

Study	Years of enrollment	Evidence	Comparator	Comparative Efficacy	Comparative Toxicity
Itoh et al. 2002 (JCOG 9505)	1995-1998	Randomized Phase 2 (E-de-esc)	dose-escalated CHOP	Did not meet primary endpoint of CR rate	Less toxic
Tsukasaki et al. 2007 (JCOG 9801)	1998-2003	Phase 3 (C)	mLSG15	Seems to have inferior CR rate	Less toxic

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 (maximum dose of 2 mg) IV once on day 1

Glucocorticoid therapy

Prednisone (Sterapred) 100 mg PO once per day on days 1 to 5

Supportive therapy

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

CNS therapy

Intrathecal triple-therapy was given during recovery phase of cycles 1, 3, and 5 after platelet count was greater than 70 × 10⁹/L.

3 doses, total

References

JCOG 9505: Itoh K, Ohtsu T, Fukuda H, Sasaki Y, Ogura M, Morishima Y, Chou T, Aikawa K, Uike N, Mizorogi F, Ohno T, Ikeda S, Sai T, Taniwaki M, Kawano F, Niimi M, Hotta T, Shimoyama M, Tobinai K; JCOG. Randomized phase II study of biweekly CHOP and dose-escalated CHOP with prophylactic use of lenograstim (glycosylated G-CSF) in aggressive non-Hodgkin's lymphoma: Japan Clinical Oncology Group Study 9505. Ann Oncol. 2002 Sep;13(9):1347-55. link to original article PubMed
JCOG 9801: 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; JCOG. 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 dosing details in manuscript PubMed NCT00145002

mLSG15

Regimen

Study	Years of enrollment	Evidence	Comparator	Comparative Efficacy
Tsukasaki et al. 2007 (JCOG 9801)	1998-2003	Phase 3 (E-esc)	CHOP-14	Seems to have superior CR rate
Ishida et al. 2015 (Kyowa 0761-003)	2010-2011	Randomized Phase 2 (C)	mLSG15 & Mogamulizumab	Did not meet primary endpoint of CR rate

Note: Ranimustine is not available in the United States and is approved only in Japan.

Chemotherapy

Vincristine (Oncovin) 1 mg/m² (maximum dose of 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
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

Glucocorticoid therapy

Prednisone (Sterapred) 40 mg/m² PO once per day on days 1, 8, 15 to 17

28-day cycle for 6 cycles

CNS therapy, prophylaxis

Cytarabine (Ara-C) 40 mg IT, admixed with MTX & prednisone
Methotrexate (MTX) 15 mg IT, admixed with Ara-C & prednisone
Prednisone (Sterapred) 10 mg IT, admixed with Ara-C & MTX

Given after cycles 1, 3, and 5 after platelets greater than 70 × 10⁹/L and within 2 days before the next cycle

References

JCOG 9801: 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; JCOG. 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 dosing details in manuscript PubMed NCT00145002
Kyowa 0761-003: 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 NCT01173887

Relapsed or refractory

Alemtuzumab monotherapy

Regimen

Study	Years of enrollment	Evidence
Sharma et al. 2016	2004-2009	Phase 2

Targeted therapy

Alemtuzumab (Campath) 30 mg IV once per day on days 1, 3, 5 (three times per week)

7-day cycle for up to 7 cycles

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 monotherapy

Regimen

Study	Years of enrollment	Evidence	Efficacy
Ishida et al. 2016 (ATLL-002)	2012-2014	Phase 2	ORR: 42% (95% CI 23-63)

Targeted therapy

Lenalidomide (Revlimid) 25 mg PO once per day

Continued indefinitely

References

ATLL-002: 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 NCT01724177

@@ Line 3: / Line 3: @@
 [[#top|Back to Top]]
 </div>
-{| class="wikitable" style="text-align:center; width:50%;"
+{{#lst:Section editor transclusions|tcl}}
-!colspan="2" align="center" style="color:white; font-size:125%; background-color:#de2d26"|'''Section editor'''
-|-
-|style="background-color:#F0F0F0"|[[File:Bdholaria.jpg|frameless|upright=0.3|center]]
-|<big>[[User:Bdholaria|Bhagirathbhai Dholaria, MBBS]]<br>Vanderbilt University<br>Nashville, TN</big>
-|-
-|}
 ''Are you looking for a regimen, but can't find it here? It is possible that we've moved it to the [[Adult T-cell leukemia-lymphoma - historical|historical regimens page]].
 {| class="wikitable" style="float:right; margin-right: 5px;"
@@ Line 17: / Line 11: @@
 |}
 {{TOC limit|limit=3}}
 =Guidelines=
 =="How I Treat"==
@@ Line 23: / Line 16: @@
 ==[https://www.nccn.org/ NCCN]==
 *[https://www.nccn.org/professionals/physician_gls/pdf/t-cell.pdf NCCN Guidelines - T-cell Lymphomas]
 =Untreated=
 ==CHOP-14 {{#subobject:3e53d9|Regimen=1}}==
 CHOP-14: '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''redniso(lo)ne every '''<u>14</u>''' days
 <br>CHOP-DI: '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''redniso(lo)ne, '''<u>D</u>'''ose-'''<u>I</u>'''ntense
 <br>I-CHOP: '''<u>I</u>'''ntensive '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''redniso(lo)ne
+<div class="toccolours" style="background-color:#eeeeee">
 ===Regimen {{#subobject:ad2f7b|Variant=1}}===
 {| class="wikitable sortable" style="width: 100%; text-align:center;"
@@ Line 55: / Line 46: @@
 |-
 |}
+<div class="toccolours" style="background-color:#b3e2cd">
 ====Chemotherapy====
 *[[Cyclophosphamide (Cytoxan)]] 750 mg/m<sup>2</sup> IV once on day 1
 *[[Doxorubicin (Adriamycin)]] 50 mg/m<sup>2</sup> IV once on day 1
 *[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> (maximum dose of 2 mg) IV once on day 1
 ====Glucocorticoid therapy====
 *[[Prednisone (Sterapred)]] 100 mg PO once per day on days 1 to 5
 ====Supportive therapy====
 *[[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'''
 ====CNS therapy====
 ''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.''
@@ Line 73: / Line 61: @@
 *[[Methotrexate (MTX)]] 15 mg IT
 *[[Prednisone (Sterapred)]] 10 mg IT
 '''3 doses, total'''
+</div></div>
 ===References===
 # '''JCOG 9505:''' Itoh K, Ohtsu T, Fukuda H, Sasaki Y, Ogura M, Morishima Y, Chou T, Aikawa K, Uike N, Mizorogi F, Ohno T, Ikeda S, Sai T, Taniwaki M, Kawano F, Niimi M, Hotta T, Shimoyama M, Tobinai K; [[Study_Groups#JCOG|JCOG]]. Randomized phase II study of biweekly CHOP and dose-escalated CHOP with prophylactic use of lenograstim (glycosylated G-CSF) in aggressive non-Hodgkin's lymphoma: Japan Clinical Oncology Group Study 9505. Ann Oncol. 2002 Sep;13(9):1347-55. [https://doi.org/10.1093/annonc/mdf287 link to original article] [https://pubmed.ncbi.nlm.nih.gov/12196359 PubMed]
 <!-- Presented in part at the 47th Annual Meeting of the American Society of Hematology, December 10-13, 2005, Atlanta, GA. -->
 # '''JCOG 9801:''' 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; [[Study_Groups#JCOG|JCOG]]. 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. [https://doi.org/10.1200/jco.2007.11.9958 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/17968021 PubMed] NCT00145002
 ==mLSG15 {{#subobject:832886|Regimen=1}}==
+<div class="toccolours" style="background-color:#eeeeee">
 ===Regimen {{#subobject:1dc050|Variant=1}}===
 {| class="wikitable sortable" style="width: 100%; text-align:center;"
@@ Line 105: / Line 90: @@
 |-
 |}
-''Ranimustine is not available in the United States and is approved only in Japan.''
+''Note: Ranimustine is not available in the United States and is approved only in Japan.''
+<div class="toccolours" style="background-color:#b3e2cd">
 ====Chemotherapy====
 *[[Vincristine (Oncovin)]] 1 mg/m<sup>2</sup> (maximum dose of 2 mg) IV once on day 1
@@ Line 114: / Line 100: @@
 *[[Etoposide (Vepesid)]] 100 mg/m<sup>2</sup> IV once per day on days 15 to 17
 *[[Carboplatin (Paraplatin)]] 250 mg/m<sup>2</sup> IV once on day 15
 ====Glucocorticoid therapy====
 *[[Prednisone (Sterapred)]] 40 mg/m<sup>2</sup> PO once per day on days 1, 8, 15 to 17
 '''28-day cycle for 6 cycles'''
 ====CNS therapy, prophylaxis====
 *[[Cytarabine (Ara-C)]] 40 mg IT, admixed with MTX & prednisone
 *[[Methotrexate (MTX)]] 15 mg IT, admixed with Ara-C & prednisone
 *[[Prednisone (Sterapred)]] 10 mg IT, admixed with Ara-C & MTX
 '''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'''
+</div></div>
 ===References===
 <!-- Presented in part at the 47th Annual Meeting of the American Society of Hematology, December 10-13, 2005, Atlanta, GA. -->
 #'''JCOG 9801:''' 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; [[Study_Groups#JCOG|JCOG]]. 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. [https://doi.org/10.1200/jco.2007.11.9958 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/17968021 PubMed] NCT00145002
 #'''Kyowa 0761-003:''' 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. [https://doi.org/10.1111/bjh.13338 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5024033/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/25733162 PubMed] NCT01173887
 =Relapsed or refractory=
 ==Alemtuzumab monotherapy {{#subobject:efc45a|Regimen=1}}==
+<div class="toccolours" style="background-color:#eeeeee">
 ===Regimen {{#subobject:32e392|Variant=1}}===
 {| class="wikitable sortable" style="width: 60%; text-align:center;"
@@ Line 148: / Line 127: @@
 |-
 |}
+<div class="toccolours" style="background-color:#b3e2cd">
 ====Targeted therapy====
 *[[Alemtuzumab (Campath)]] 30 mg IV once per day on days 1, 3, 5 (three times per week)
 '''7-day cycle for up to 7 cycles'''
+</div></div>
 ===References===
 <!-- 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/pmc/articles/PMC5215752/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/27486175 PubMed]
 ==Lenalidomide monotherapy {{#subobject:b2b90e|Regimen=1}}==
+<div class="toccolours" style="background-color:#eeeeee">
 ===Regimen {{#subobject:662944|Variant=1}}===
 {| class="wikitable sortable" style="width: 80%; text-align:center;"
@@ Line 173: / Line 150: @@
 |-
 |}
+<div class="toccolours" style="background-color:#b3e2cd">
 ====Targeted therapy====
 *[[Lenalidomide (Revlimid)]] 25 mg PO once per day
 '''Continued indefinitely'''
+</div></div>
 ===References===
 # '''ATLL-002:''' 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. [https://doi.org/10.1200/JCO.2016.67.7732 link to original article] [https://pubmed.ncbi.nlm.nih.gov/27621400 PubMed] NCT01724177
 [[Category:Adult T-cell leukemia-lymphoma regimens]]
 [[Category:Disease-specific pages]]

Difference between revisions of "Adult T-cell leukemia-lymphoma"

Revision as of 12:32, 29 October 2022

Contents

Guidelines

"How I Treat"

NCCN

Untreated

CHOP-14

Regimen

Chemotherapy

Glucocorticoid therapy

Supportive therapy

CNS therapy

References

mLSG15

Regimen

Chemotherapy

Glucocorticoid therapy

CNS therapy, prophylaxis

References

Relapsed or refractory

Alemtuzumab monotherapy

Regimen

Targeted therapy

References

Lenalidomide monotherapy

Regimen

Targeted therapy

References

Navigation menu

Search