Difference between revisions of "Staging page"

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[[#top|Back to Top]]
 
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</div>
 
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{{#lst:Section editor transclusions|tcl}}
 
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''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]].
 
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{| class="wikitable" style="float:right; margin-right: 5px;"
 
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|<div style="background-color: #fee0d1; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}" align="right"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]]  |?Regimen |limit=10000|format=sum}} [[Tutorial#Regimens|regimens]] on this page</b></font></div>
 
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<div style="background-color: #deebf6; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]]  |?Variant |limit=10000|format=sum}} [[Tutorial#Variants|variants]] on this page</b></font></div>
 
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|}
 
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{{TOC limit|limit=3}}
 
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=Guidelines=
 
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=="How I Treat"==
 
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*'''2021:''' Cook & Phillips [https://doi.org/10.1182/blood.2019004045 How I treat adult T-cell leukemia/lymphoma]
 
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==[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]
 
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=Untreated=
 
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==CHOP-14 {{#subobject:3e53d9|Regimen=1}}==
 
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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
 
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<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
 
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<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
 
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<div class="toccolours" style="background-color:#eeeeee">
 
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===Regimen {{#subobject:ad2f7b|Variant=1}}===
 
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{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
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!style="width: 17%"|Study
 
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!style="width: 15%"|Years of enrollment
 
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!style="width: 17%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
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!style="width: 17%"|Comparator
 
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!style="width: 17%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
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!style="width: 17%"|[[Levels_of_Evidence#Toxicity|Comparative Toxicity]]
 
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|-
 
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|[https://doi.org/10.1093/annonc/mdf287 Itoh et al. 2002 (JCOG 9505)]
 
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|1995-1998
 
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|style="background-color:#1a9851"|Randomized Phase 2 (E-de-esc)
 
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|[[#Dose-escalated_CHOP_99|dose-escalated CHOP]]
 
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| style="background-color:#ffffbf" |Did not meet primary endpoint of CR rate
 
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| style="background-color:#1a9850" |Less toxic
 
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|-
 
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|[https://doi.org/10.1200/jco.2007.11.9958 Tsukasaki et al. 2007 (JCOG 9801)]
 
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|1998-2003
 
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|style="background-color:#1a9851"|Phase 3 (C)
 
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|[[#mLSG15|mLSG15]]
 
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|style="background-color:#fc8d59"|Seems to have inferior CR rate
 
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| style="background-color:#1a9850" |Less toxic
 
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|-
 
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|}
 
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<div class="toccolours" style="background-color:#b3e2cd">
 
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====Chemotherapy====
 
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*[[Cyclophosphamide (Cytoxan)]] 750 mg/m<sup>2</sup> IV once on day 1
 
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*[[Doxorubicin (Adriamycin)]] 50 mg/m<sup>2</sup> IV once on day 1
 
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*[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> (maximum dose of 2 mg) IV once on day 1
 
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====Glucocorticoid therapy====
 
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*[[Prednisone (Sterapred)]] 100 mg PO once per day on days 1 to 5
 
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====Supportive therapy====
 
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*[[Filgrastim (Neupogen)]] given once ANC decreased to less than 1000/uL and continued once per day until count increased to greater than 5000/uL
 
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'''14-day cycle for 8 cycles'''
 
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====CNS therapy====
 
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''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.''
 
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*[[Cytarabine (Ara-C)]] 40 mg IT
 
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*[[Methotrexate (MTX)]] 15 mg IT
 
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*[[Prednisone (Sterapred)]] 10 mg IT
 
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'''3 doses, total'''
 
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</div></div>
 
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===References===
 
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# '''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]
 
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<!-- Presented in part at the 47th Annual Meeting of the American Society of Hematology, December 10-13, 2005, Atlanta, GA. -->
 
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# '''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
 
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==mLSG15 {{#subobject:832886|Regimen=1}}==
 
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<div class="toccolours" style="background-color:#eeeeee">
 
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===Regimen {{#subobject:1dc050|Variant=1}}===
 
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{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
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!style="width: 20%"|Study
 
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!style="width: 20%"|Years of enrollment
 
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!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
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!style="width: 20%"|Comparator
 
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!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
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|-
 
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|[https://doi.org/10.1200/jco.2007.11.9958 Tsukasaki et al. 2007 (JCOG 9801)]
 
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|1998-2003
 
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|style="background-color:#1a9851"|Phase 3 (E-esc)
 
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|[[#CHOP-14|CHOP-14]]
 
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|style="background-color:#91cf60"|Seems to have superior CR rate
 
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|-
 
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|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5024033/ Ishida et al. 2015 (Kyowa 0761-003)]
 
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|2010-2011
 
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|style="background-color:#1a9851"|Randomized Phase 2 (C)
 
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|[[#mLSG15_.26_Mogamulizumab_99|mLSG15 & Mogamulizumab]]
 
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|style="background-color:#ffffbf"|Did not meet primary endpoint of CR rate
 
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|-
 
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|}
 
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''Ranimustine is not available in the United States and is approved only in Japan.''
 
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====Chemotherapy====
 
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*[[Vincristine (Oncovin)]] 1 mg/m<sup>2</sup> (maximum dose of 2 mg) IV once on day 1
 
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*[[Cyclophosphamide (Cytoxan)]] 350 mg/m<sup>2</sup> IV once on day 1
 
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*[[Doxorubicin (Adriamycin)]] 40 mg/m<sup>2</sup> IV once on day 1, then 30 mg/m<sup>2</sup> IV once on day 8
 
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*[[Ranimustine (Cymerin)]] 60 mg/m<sup>2</sup> IV once on day 8
 
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*[[Vindesine (Eldisine)]] 2.4 mg/m<sup>2</sup> IV once on day 15
 
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*[[Etoposide (Vepesid)]] 100 mg/m<sup>2</sup> IV once per day on days 15 to 17
 
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*[[Carboplatin (Paraplatin)]] 250 mg/m<sup>2</sup> IV once on day 15
 
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====Glucocorticoid therapy====
 
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*[[Prednisone (Sterapred)]] 40 mg/m<sup>2</sup> PO once per day on days 1, 8, 15 to 17
 
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'''28-day cycle for 6 cycles'''
 
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====CNS therapy, prophylaxis====
 
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*[[Cytarabine (Ara-C)]] 40 mg IT, admixed with MTX & prednisone
 
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*[[Methotrexate (MTX)]] 15 mg IT, admixed with Ara-C & prednisone
 
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*[[Prednisone (Sterapred)]] 10 mg IT, admixed with Ara-C & MTX
 
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'''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'''
 
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</div></div>
 
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===References===
 
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<!-- Presented in part at the 47th Annual Meeting of the American Society of Hematology, December 10-13, 2005, Atlanta, GA. -->
 
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#'''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
 
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#'''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
 
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=Relapsed or refractory=
 
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==Alemtuzumab monotherapy {{#subobject:efc45a|Regimen=1}}==
 
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<div class="toccolours" style="background-color:#eeeeee">
 
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===Regimen {{#subobject:32e392|Variant=1}}===
 
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{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
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!style="width: 33%"|Study
 
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!style="width: 33%"|Years of enrollment
 
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!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
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|-
 
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|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5215752/ Sharma et al. 2016]
 
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|2004-2009
 
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|style="background-color:#91cf61"|Phase 2
 
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|-
 
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|}
 
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<div class="toccolours" style="background-color:#b3e2cd">
 
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====Targeted therapy====
 
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*[[Alemtuzumab (Campath)]] 30 mg IV once per day on days 1, 3, 5 (three times per week)
 
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'''7-day cycle for up to 7 cycles'''
 
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</div></div>
 
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===References===
 
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<!-- Presented in abstract form at the 50th Annual Meeting of the American Society of Hematology, San Francisco, CA, December 6–9, 2008. -->
 
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# 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]
 
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==Lenalidomide monotherapy {{#subobject:b2b90e|Regimen=1}}==
 
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<div class="toccolours" style="background-color:#eeeeee">
 
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===Regimen {{#subobject:662944|Variant=1}}===
 
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{| class="wikitable sortable" style="width: 80%; text-align:center;"
 
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!style="width: 25%"|Study
 
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!style="width: 25%"|Years of enrollment
 
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!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
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!style="width: 25%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
 
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|-
 
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|[https://doi.org/10.1200/JCO.2016.67.7732 Ishida et al. 2016 (ATLL-002)]
 
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|2012-2014
 
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|style="background-color:#91cf61"|Phase 2
 
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|ORR: 42% (95% CI 23-63)
 
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|-
 
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|}
 
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<div class="toccolours" style="background-color:#b3e2cd">
 
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====Targeted therapy====
 
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*[[Lenalidomide (Revlimid)]] 25 mg PO once per day
 
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'''Continued indefinitely'''
 
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</div></div>
 
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===References===
 
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# '''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
 
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[[Category:Adult T-cell leukemia-lymphoma regimens]]
 
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[[Category:Disease-specific pages]]
 
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[[Category:Acute leukemias]]
 
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[[Category:T-cell lymphomas]]
 
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[[Category:T-cell leukemias]]
 

Latest revision as of 00:13, 18 June 2023

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