Difference between revisions of "T-cell prolymphocytic leukemia"
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=Guidelines= | =Guidelines= | ||
=="How I Treat"== | =="How I Treat"== | ||
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==[https://www.nccn.org/ NCCN]== | ==[https://www.nccn.org/ NCCN]== | ||
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*[https://www.nccn.org/professionals/physician_gls/pdf/t-cell.pdf NCCN Guidelines - T-cell Lymphomas] | *[https://www.nccn.org/professionals/physician_gls/pdf/t-cell.pdf NCCN Guidelines - T-cell Lymphomas] | ||
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=Diagnosis, staging and treatment response criteria (TPLL-ISG)= | =Diagnosis, staging and treatment response criteria (TPLL-ISG)= | ||
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*'''2019:''' Staber et al. [https://doi.org/10.1182/blood.2019000402 Consensus criteria for diagnosis, staging, and treatment response assessment of T-cell prolymphocytic leukemia] | *'''2019:''' Staber et al. [https://doi.org/10.1182/blood.2019000402 Consensus criteria for diagnosis, staging, and treatment response assessment of T-cell prolymphocytic leukemia] | ||
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=Upfront induction therapy= | =Upfront induction therapy= | ||
==Alemtuzumab monotherapy {{#subobject:ab5318|Regimen=1}}== | ==Alemtuzumab monotherapy {{#subobject:ab5318|Regimen=1}}== | ||
| − | + | <div class="toccolours" style="background-color:#eeeeee"> | |
===Regimen {{#subobject:893a|Variant=1}}=== | ===Regimen {{#subobject:893a|Variant=1}}=== | ||
{| class="wikitable" style="width: 60%; text-align:center;" | {| class="wikitable" style="width: 60%; text-align:center;" | ||
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| + | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Targeted therapy==== | ====Targeted therapy==== | ||
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* [[Alemtuzumab (Campath)]] as follows: | * [[Alemtuzumab (Campath)]] as follows: | ||
**Week 1: 3 mg IV once on day 1, then 10 mg IV once on day 2, then 30 mg IV once on day 3 | **Week 1: 3 mg IV once on day 1, then 10 mg IV once on day 2, then 30 mg IV once on day 3 | ||
**Week 2 onwards: 30 mg IV three times weekly | **Week 2 onwards: 30 mg IV three times weekly | ||
| − | |||
'''Continued until achievement of CR or best response or for up to a total of 3 months''' | '''Continued until achievement of CR or best response or for up to a total of 3 months''' | ||
| − | + | </div></div> | |
===References=== | ===References=== | ||
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#Dearden CE, Matutes E, Cazin B, Tjønnfjord GE, Parreira A, Nomdedeu B, Leoni P, Clark FJ, Radia D, Rassam SM, Roques T, Ketterer N, Brito-Babapulle V, Dyer MJ, Catovsky D. High remission rate in T-cell prolymphocytic leukemia with CAMPATH-1H. Blood. 2001 Sep 15;98(6):1721-6. [https://doi.org/10.1182/blood.v98.6.1721 link to original article] [https://pubmed.ncbi.nlm.nih.gov/11535503 PubMed] | #Dearden CE, Matutes E, Cazin B, Tjønnfjord GE, Parreira A, Nomdedeu B, Leoni P, Clark FJ, Radia D, Rassam SM, Roques T, Ketterer N, Brito-Babapulle V, Dyer MJ, Catovsky D. High remission rate in T-cell prolymphocytic leukemia with CAMPATH-1H. Blood. 2001 Sep 15;98(6):1721-6. [https://doi.org/10.1182/blood.v98.6.1721 link to original article] [https://pubmed.ncbi.nlm.nih.gov/11535503 PubMed] | ||
#Dearden CE, Khot A, Else M, Hamblin M, Grand E, Roy A, Hewamana S, Matutes E, Catovsky D. Alemtuzumab therapy in T-cell prolymphocytic leukemia: comparing efficacy in a series treated intravenously and a study piloting the subcutaneous route. Blood. 2011 Nov 24;118(22):5799-802. Epub 2011 Sep 26. [https://doi.org/10.1182/blood-2011-08-372854 link to original article] [https://pubmed.ncbi.nlm.nih.gov/21948296 PubMed] | #Dearden CE, Khot A, Else M, Hamblin M, Grand E, Roy A, Hewamana S, Matutes E, Catovsky D. Alemtuzumab therapy in T-cell prolymphocytic leukemia: comparing efficacy in a series treated intravenously and a study piloting the subcutaneous route. Blood. 2011 Nov 24;118(22):5799-802. Epub 2011 Sep 26. [https://doi.org/10.1182/blood-2011-08-372854 link to original article] [https://pubmed.ncbi.nlm.nih.gov/21948296 PubMed] | ||
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==Pentostatin & Alemtuzumab {{#subobject:aacb018|Regimen=1}}== | ==Pentostatin & Alemtuzumab {{#subobject:aacb018|Regimen=1}}== | ||
| − | + | <div class="toccolours" style="background-color:#eeeeee"> | |
===Regimen {{#subobject:881cj3a|Variant=1}}=== | ===Regimen {{#subobject:881cj3a|Variant=1}}=== | ||
{| class="wikitable" style="width: 60%; text-align:center;" | {| class="wikitable" style="width: 60%; text-align:center;" | ||
| Line 72: | Line 58: | ||
|ORR: 69%, CR: 62% | |ORR: 69%, CR: 62% | ||
|} | |} | ||
| + | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Targeted therapy==== | ====Targeted therapy==== | ||
| − | |||
*[[Alemtuzumab (Campath)]] as follows: | *[[Alemtuzumab (Campath)]] as follows: | ||
**Week 1: 3 mg IV once on day 1, then 10 mg IV once on day 2, then 30 mg IV once on day 3 | **Week 1: 3 mg IV once on day 1, then 10 mg IV once on day 2, then 30 mg IV once on day 3 | ||
| Line 81: | Line 67: | ||
**Weeks 1 to 4: 4 mg/m<sup>2</sup> IV once per week | **Weeks 1 to 4: 4 mg/m<sup>2</sup> IV once per week | ||
**Week 5 onwards: 4 mg/m<sup>2</sup> IV once every 2 weeks | **Week 5 onwards: 4 mg/m<sup>2</sup> IV once every 2 weeks | ||
| − | |||
'''Continued until achievement of CR or best response or for up to a total of 3 months (total of 14 doses of pentostatin)''' | '''Continued until achievement of CR or best response or for up to a total of 3 months (total of 14 doses of pentostatin)''' | ||
| − | + | </div></div> | |
===References=== | ===References=== | ||
#'''MDACC 2004-0408:''' Ravandi F, Aribi A, O'Brien S, Faderl S, Jones D, Ferrajoli A, Huang X, York S, Pierce S, Wierda W, Kontoyiannis D, Verstovsek S, Pro B, Fayad L, Keating M, Kantarjian H. Phase II study of alemtuzumab in combination with pentostatin in patients with T-cell neoplasms. J Clin Oncol. 2009 Nov 10;27(32):5425-30. Epub 2009 Oct 5. [https://doi.org/10.1200/JCO.2009.22.6688 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4881363/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/19805674 PubMed] | #'''MDACC 2004-0408:''' Ravandi F, Aribi A, O'Brien S, Faderl S, Jones D, Ferrajoli A, Huang X, York S, Pierce S, Wierda W, Kontoyiannis D, Verstovsek S, Pro B, Fayad L, Keating M, Kantarjian H. Phase II study of alemtuzumab in combination with pentostatin in patients with T-cell neoplasms. J Clin Oncol. 2009 Nov 10;27(32):5425-30. Epub 2009 Oct 5. [https://doi.org/10.1200/JCO.2009.22.6688 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4881363/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/19805674 PubMed] | ||
| − | |||
=Relapsed or refractory, salvage therapy= | =Relapsed or refractory, salvage therapy= | ||
==Bendamustine monotherapy {{#subobject:a1kc88|Regimen=1}}== | ==Bendamustine monotherapy {{#subobject:a1kc88|Regimen=1}}== | ||
| − | + | <div class="toccolours" style="background-color:#eeeeee"> | |
===Regimen {{#subobject:90ucj3a|Variant=1}}=== | ===Regimen {{#subobject:90ucj3a|Variant=1}}=== | ||
{| class="wikitable" style="width: 40%; text-align:center;" | {| class="wikitable" style="width: 40%; text-align:center;" | ||
| Line 98: | Line 82: | ||
| style="background-color:#ffffbe" |Retrospective | | style="background-color:#ffffbe" |Retrospective | ||
|} | |} | ||
| + | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Chemotherapy==== | ====Chemotherapy==== | ||
* [[Bendamustine]] 70 to 120 mg/m<sup>2</sup> IV once per day on days 1 & 2 | * [[Bendamustine]] 70 to 120 mg/m<sup>2</sup> IV once per day on days 1 & 2 | ||
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'''21-day cycle for 6 cycles''' | '''21-day cycle for 6 cycles''' | ||
| − | + | </div></div> | |
===References=== | ===References=== | ||
| − | |||
# '''Retrospective:''' Herbaux C, Genet P, Bouabdallah K, Pignon JM, Debarri H, Guidez S, Betrian S, Leleu X, Facon T, Morschhauser F, Damaj G, Cazin B, Ysebaert L. Bendamustine is effective in T-cell prolymphocytic leukaemia. Br J Haematol. 2015 Mar;168(6):916-9. [https://doi.org/full/10.1111/bjh.13175 link to original article] [https://pubmed.ncbi.nlm.nih.gov/25316212 PubMed] | # '''Retrospective:''' Herbaux C, Genet P, Bouabdallah K, Pignon JM, Debarri H, Guidez S, Betrian S, Leleu X, Facon T, Morschhauser F, Damaj G, Cazin B, Ysebaert L. Bendamustine is effective in T-cell prolymphocytic leukaemia. Br J Haematol. 2015 Mar;168(6):916-9. [https://doi.org/full/10.1111/bjh.13175 link to original article] [https://pubmed.ncbi.nlm.nih.gov/25316212 PubMed] | ||
| − | |||
==Pentostatin & Alemtuzumab {{#subobject:a1kb018|Regimen=1}}== | ==Pentostatin & Alemtuzumab {{#subobject:a1kb018|Regimen=1}}== | ||
| − | + | <div class="toccolours" style="background-color:#eeeeee"> | |
===Regimen {{#subobject:991cj3a|Variant=1}}=== | ===Regimen {{#subobject:991cj3a|Variant=1}}=== | ||
{| class="wikitable" style="width: 60%; text-align:center;" | {| class="wikitable" style="width: 60%; text-align:center;" | ||
| Line 119: | Line 101: | ||
|ORR: 69%, CR: 62% | |ORR: 69%, CR: 62% | ||
|} | |} | ||
| + | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Targeted therapy==== | ====Targeted therapy==== | ||
| − | |||
*[[Alemtuzumab (Campath)]] as follows: | *[[Alemtuzumab (Campath)]] as follows: | ||
**Week 1: 3 mg IV once on day 1, then 10 mg IV once on day 2, then 30 mg IV once on day 3 | **Week 1: 3 mg IV once on day 1, then 10 mg IV once on day 2, then 30 mg IV once on day 3 | ||
| Line 128: | Line 110: | ||
**Weeks 1 to 4: 4 mg/m<sup>2</sup> IV once per week | **Weeks 1 to 4: 4 mg/m<sup>2</sup> IV once per week | ||
**Week 5 onwards: 4 mg/m<sup>2</sup> IV once every 2 weeks | **Week 5 onwards: 4 mg/m<sup>2</sup> IV once every 2 weeks | ||
| − | |||
'''Continued until achievement of CR or best response or for up to a total of 3 months (total of 14 doses of pentostatin)''' | '''Continued until achievement of CR or best response or for up to a total of 3 months (total of 14 doses of pentostatin)''' | ||
| − | + | </div></div> | |
===References=== | ===References=== | ||
#'''MDACC 2004-0408:''' Ravandi F, Aribi A, O'Brien S, Faderl S, Jones D, Ferrajoli A, Huang X, York S, Pierce S, Wierda W, Kontoyiannis D, Verstovsek S, Pro B, Fayad L, Keating M, Kantarjian H. Phase II study of alemtuzumab in combination with pentostatin in patients with T-cell neoplasms. J Clin Oncol. 2009 Nov 10;27(32):5425-30. Epub 2009 Oct 5. [https://doi.org/10.1200/JCO.2009.22.6688 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4881363/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/19805674 PubMed] | #'''MDACC 2004-0408:''' Ravandi F, Aribi A, O'Brien S, Faderl S, Jones D, Ferrajoli A, Huang X, York S, Pierce S, Wierda W, Kontoyiannis D, Verstovsek S, Pro B, Fayad L, Keating M, Kantarjian H. Phase II study of alemtuzumab in combination with pentostatin in patients with T-cell neoplasms. J Clin Oncol. 2009 Nov 10;27(32):5425-30. Epub 2009 Oct 5. [https://doi.org/10.1200/JCO.2009.22.6688 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4881363/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/19805674 PubMed] | ||
| − | |||
==Ibrutinib & Venetoclax {{#subobject:a1uh18|Regimen=1}}== | ==Ibrutinib & Venetoclax {{#subobject:a1uh18|Regimen=1}}== | ||
| − | + | <div class="toccolours" style="background-color:#eeeeee"> | |
===Regimen {{#subobject:991ica|Variant=1}}=== | ===Regimen {{#subobject:991ica|Variant=1}}=== | ||
{| class="wikitable" style="width: 40%; text-align:center;" | {| class="wikitable" style="width: 40%; text-align:center;" | ||
| Line 145: | Line 125: | ||
|- | |- | ||
|} | |} | ||
| + | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Targeted therapy==== | ====Targeted therapy==== | ||
* [[Ibrutinib (Imbruvica)|Ibrutinib]] 420 mg PO once per day | * [[Ibrutinib (Imbruvica)|Ibrutinib]] 420 mg PO once per day | ||
* [[Venetoclax (Venclexta)|Venetoclax]] 400 to 600 mg PO once per day | * [[Venetoclax (Venclexta)|Venetoclax]] 400 to 600 mg PO once per day | ||
| − | |||
'''Continued indefinitely''' | '''Continued indefinitely''' | ||
| − | + | </div></div> | |
===References=== | ===References=== | ||
| − | |||
# '''Abstract:''' Kornauth C, Herbaux C, Boidol B, Guillemette C, Caron P, Poulain S, et al. Combination of Venetoclax and Ibrutinib Increases bcl2-Dependent Apoptotic Priming, Reduces ITK-Phosphorylation and Is Clinically Promising in Relapsed/Refractory T-Prolymphocytic Leukemia. Blood. 2019;134(Supplement_1):3965. [https://ashpublications.org/blood/article/134/Supplement_1/3965/424160/Combination-of-Venetoclax-and-Ibrutinib-Increases link to abstract] | # '''Abstract:''' Kornauth C, Herbaux C, Boidol B, Guillemette C, Caron P, Poulain S, et al. Combination of Venetoclax and Ibrutinib Increases bcl2-Dependent Apoptotic Priming, Reduces ITK-Phosphorylation and Is Clinically Promising in Relapsed/Refractory T-Prolymphocytic Leukemia. Blood. 2019;134(Supplement_1):3965. [https://ashpublications.org/blood/article/134/Supplement_1/3965/424160/Combination-of-Venetoclax-and-Ibrutinib-Increases link to abstract] | ||
| − | |||
=Consolidation therapy after upfront or salvage therapy= | =Consolidation therapy after upfront or salvage therapy= | ||
| − | |||
'''[[Allogeneic HSCT]]''' evaluation suggested in eligible patients. | '''[[Allogeneic HSCT]]''' evaluation suggested in eligible patients. | ||
| − | + | </div></div> | |
===References=== | ===References=== | ||
# Krishnan B, Else M, Tjonnfjord GE, Cazin B, Carney D, Carter J, Ketterer N, Catovsky D, Ethell M, Matutes E, Dearden CE. Stem cell transplantation after alemtuzumab in T-cell prolymphocytic leukaemia results in longer survival than after alemtuzumab alone: a multicentre retrospective study. Br J Haematol. 2010 Jun;149(6):907-10. [https://doi.org/full/10.1111/j.1365-2141.2010.08134.x link to original article] [https://pubmed.ncbi.nlm.nih.gov/20201944 PubMed] | # Krishnan B, Else M, Tjonnfjord GE, Cazin B, Carney D, Carter J, Ketterer N, Catovsky D, Ethell M, Matutes E, Dearden CE. Stem cell transplantation after alemtuzumab in T-cell prolymphocytic leukaemia results in longer survival than after alemtuzumab alone: a multicentre retrospective study. Br J Haematol. 2010 Jun;149(6):907-10. [https://doi.org/full/10.1111/j.1365-2141.2010.08134.x link to original article] [https://pubmed.ncbi.nlm.nih.gov/20201944 PubMed] | ||
# Kalaycio ME, Kukreja M, Woolfrey AE, Szer J, Cortes J, Maziarz RT, Bolwell BJ, Buser A, Copelan E, Gale RP, Gupta V, Maharaj D, Marks DI, Pavletic SZ, Horowitz MM, Arora M. Allogeneic hematopoietic cell transplant for prolymphocytic leukemia. Biol Blood Marrow Transplant. 2010 Apr;16(4):543-7. [https://doi.org/10.1016/j.bbmt.2009.11.021 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2839005/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/19961946 PubMed] | # Kalaycio ME, Kukreja M, Woolfrey AE, Szer J, Cortes J, Maziarz RT, Bolwell BJ, Buser A, Copelan E, Gale RP, Gupta V, Maharaj D, Marks DI, Pavletic SZ, Horowitz MM, Arora M. Allogeneic hematopoietic cell transplant for prolymphocytic leukemia. Biol Blood Marrow Transplant. 2010 Apr;16(4):543-7. [https://doi.org/10.1016/j.bbmt.2009.11.021 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2839005/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/19961946 PubMed] | ||
# '''Retrospective:''' Wiktor-Jedrzejczak W, Dearden C, de Wreede L, van Biezen A, Brinch L, Leblond V, Brune M, Volin L, Kazmi M, Nagler A, Schetelig J, de Witte T, Dreger P; EBMT Chronic Leukemia Working Party. Hematopoietic stem cell transplantation in T-prolymphocytic leukemia: a retrospective study from the European Group for Blood and Marrow Transplantation and the Royal Marsden Consortium. Leukemia. 2012 May;26(5):972-6. [https://www.nature.com/articles/leu2011304 link to original article] [https://pubmed.ncbi.nlm.nih.gov/22116553 PubMed] | # '''Retrospective:''' Wiktor-Jedrzejczak W, Dearden C, de Wreede L, van Biezen A, Brinch L, Leblond V, Brune M, Volin L, Kazmi M, Nagler A, Schetelig J, de Witte T, Dreger P; EBMT Chronic Leukemia Working Party. Hematopoietic stem cell transplantation in T-prolymphocytic leukemia: a retrospective study from the European Group for Blood and Marrow Transplantation and the Royal Marsden Consortium. Leukemia. 2012 May;26(5):972-6. [https://www.nature.com/articles/leu2011304 link to original article] [https://pubmed.ncbi.nlm.nih.gov/22116553 PubMed] | ||
| − | |||
[[Category:T-cell prolymphocytic leukemia regimens]] | [[Category:T-cell prolymphocytic leukemia regimens]] | ||
[[Category:Disease-specific pages]] | [[Category:Disease-specific pages]] | ||
[[Category:T-cell leukemias]] | [[Category:T-cell leukemias]] | ||
Revision as of 12:43, 29 October 2022
5 regimens on this page
5 variants on this page
|
Guidelines
"How I Treat"
- 2012: Dearden How I treat prolymphocytic leukemia
NCCN
Diagnosis, staging and treatment response criteria (TPLL-ISG)
- 2019: Staber et al. Consensus criteria for diagnosis, staging, and treatment response assessment of T-cell prolymphocytic leukemia
Upfront induction therapy
Alemtuzumab monotherapy
Regimen
| Study | Evidence | Efficacy |
|---|---|---|
| Dearden et al. 2001 | Non-randomized | ORR: 76%, CR: 60% |
| Dearden et al. 2011 | Non-randomized | ORR: 91%, CR: 81% |
Targeted therapy
- Alemtuzumab (Campath) as follows:
- Week 1: 3 mg IV once on day 1, then 10 mg IV once on day 2, then 30 mg IV once on day 3
- Week 2 onwards: 30 mg IV three times weekly
Continued until achievement of CR or best response or for up to a total of 3 months
References
- Dearden CE, Matutes E, Cazin B, Tjønnfjord GE, Parreira A, Nomdedeu B, Leoni P, Clark FJ, Radia D, Rassam SM, Roques T, Ketterer N, Brito-Babapulle V, Dyer MJ, Catovsky D. High remission rate in T-cell prolymphocytic leukemia with CAMPATH-1H. Blood. 2001 Sep 15;98(6):1721-6. link to original article PubMed
- Dearden CE, Khot A, Else M, Hamblin M, Grand E, Roy A, Hewamana S, Matutes E, Catovsky D. Alemtuzumab therapy in T-cell prolymphocytic leukemia: comparing efficacy in a series treated intravenously and a study piloting the subcutaneous route. Blood. 2011 Nov 24;118(22):5799-802. Epub 2011 Sep 26. link to original article PubMed
Pentostatin & Alemtuzumab
Regimen
| Study | Evidence | Efficacy |
|---|---|---|
| Ravandi et al. 2009 (MDACC 2004-0408) | Non-randomized | ORR: 69%, CR: 62% |
Targeted therapy
- Alemtuzumab (Campath) as follows:
- Week 1: 3 mg IV once on day 1, then 10 mg IV once on day 2, then 30 mg IV once on day 3
- Week 2 onwards: 30 mg IV three times weekly
Chemotherapy
- Pentostatin (Nipent) as follows:
- Weeks 1 to 4: 4 mg/m2 IV once per week
- Week 5 onwards: 4 mg/m2 IV once every 2 weeks
Continued until achievement of CR or best response or for up to a total of 3 months (total of 14 doses of pentostatin)
References
- MDACC 2004-0408: Ravandi F, Aribi A, O'Brien S, Faderl S, Jones D, Ferrajoli A, Huang X, York S, Pierce S, Wierda W, Kontoyiannis D, Verstovsek S, Pro B, Fayad L, Keating M, Kantarjian H. Phase II study of alemtuzumab in combination with pentostatin in patients with T-cell neoplasms. J Clin Oncol. 2009 Nov 10;27(32):5425-30. Epub 2009 Oct 5. link to original article link to PMC article PubMed
Relapsed or refractory, salvage therapy
Bendamustine monotherapy
Regimen
| Study | Evidence |
|---|---|
| Herbaux et al. 2014 | Retrospective |
References
- Retrospective: Herbaux C, Genet P, Bouabdallah K, Pignon JM, Debarri H, Guidez S, Betrian S, Leleu X, Facon T, Morschhauser F, Damaj G, Cazin B, Ysebaert L. Bendamustine is effective in T-cell prolymphocytic leukaemia. Br J Haematol. 2015 Mar;168(6):916-9. link to original article PubMed
Pentostatin & Alemtuzumab
Regimen
| Study | Evidence | Efficacy |
|---|---|---|
| Ravandi et al. 2009 (MDACC 2004-0408) | Non-randomized | ORR: 69%, CR: 62% |
Targeted therapy
- Alemtuzumab (Campath) as follows:
- Week 1: 3 mg IV once on day 1, then 10 mg IV once on day 2, then 30 mg IV once on day 3
- Week 2 onwards: 30 mg IV three times weekly
Chemotherapy
- Pentostatin (Nipent) as follows:
- Weeks 1 to 4: 4 mg/m2 IV once per week
- Week 5 onwards: 4 mg/m2 IV once every 2 weeks
Continued until achievement of CR or best response or for up to a total of 3 months (total of 14 doses of pentostatin)
References
- MDACC 2004-0408: Ravandi F, Aribi A, O'Brien S, Faderl S, Jones D, Ferrajoli A, Huang X, York S, Pierce S, Wierda W, Kontoyiannis D, Verstovsek S, Pro B, Fayad L, Keating M, Kantarjian H. Phase II study of alemtuzumab in combination with pentostatin in patients with T-cell neoplasms. J Clin Oncol. 2009 Nov 10;27(32):5425-30. Epub 2009 Oct 5. link to original article link to PMC article PubMed
Ibrutinib & Venetoclax
Regimen
| Study | Evidence |
|---|---|
| Kornauth et al. 2019 | Non-randomized |
Targeted therapy
- Ibrutinib 420 mg PO once per day
- Venetoclax 400 to 600 mg PO once per day
Continued indefinitely
References
- Abstract: Kornauth C, Herbaux C, Boidol B, Guillemette C, Caron P, Poulain S, et al. Combination of Venetoclax and Ibrutinib Increases bcl2-Dependent Apoptotic Priming, Reduces ITK-Phosphorylation and Is Clinically Promising in Relapsed/Refractory T-Prolymphocytic Leukemia. Blood. 2019;134(Supplement_1):3965. link to abstract
Consolidation therapy after upfront or salvage therapy
Allogeneic HSCT evaluation suggested in eligible patients.
References
- Krishnan B, Else M, Tjonnfjord GE, Cazin B, Carney D, Carter J, Ketterer N, Catovsky D, Ethell M, Matutes E, Dearden CE. Stem cell transplantation after alemtuzumab in T-cell prolymphocytic leukaemia results in longer survival than after alemtuzumab alone: a multicentre retrospective study. Br J Haematol. 2010 Jun;149(6):907-10. link to original article PubMed
- Kalaycio ME, Kukreja M, Woolfrey AE, Szer J, Cortes J, Maziarz RT, Bolwell BJ, Buser A, Copelan E, Gale RP, Gupta V, Maharaj D, Marks DI, Pavletic SZ, Horowitz MM, Arora M. Allogeneic hematopoietic cell transplant for prolymphocytic leukemia. Biol Blood Marrow Transplant. 2010 Apr;16(4):543-7. link to original article link to PMC article PubMed
- Retrospective: Wiktor-Jedrzejczak W, Dearden C, de Wreede L, van Biezen A, Brinch L, Leblond V, Brune M, Volin L, Kazmi M, Nagler A, Schetelig J, de Witte T, Dreger P; EBMT Chronic Leukemia Working Party. Hematopoietic stem cell transplantation in T-prolymphocytic leukemia: a retrospective study from the European Group for Blood and Marrow Transplantation and the Royal Marsden Consortium. Leukemia. 2012 May;26(5):972-6. link to original article PubMed