Difference between revisions of "T-cell prolymphocytic leukemia"
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(added some regimens, reference. please confirm that early clinical reports/abstracts are ok (ven/ibrutinib regimen)) Tag: visualeditor |
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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] | ||
− | + | =Diagnosis, staging and treatment response criteria (TPLL-ISG)= | |
*'''2019:''' Staber et al. [https://ashpublications.org/blood/article-lookup/doi/10.1182/blood.2019000402 Consensus criteria for diagnosis, staging, and treatment response assessment of T-cell prolymphocytic leukemia] | *'''2019:''' Staber et al. [https://ashpublications.org/blood/article-lookup/doi/10.1182/blood.2019000402 Consensus criteria for diagnosis, staging, and treatment response assessment of T-cell prolymphocytic leukemia] | ||
Line 29: | Line 29: | ||
|} | |} | ||
===Regimen {{#subobject:893a|Variant=1}}=== | ===Regimen {{#subobject:893a|Variant=1}}=== | ||
− | {| class="wikitable" style="width: | + | {| class="wikitable" style="width: 75%; text-align:center;" |
− | ! style="width: | + | !style="width: 33%"|Study |
− | ! style="width: | + | !style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]] |
− | !Efficacy | + | !style="width: 33%"|[[Levels_of_Evidence#Efficacy|Efficacy]] |
|- | |- | ||
|[https://ashpublications.org/blood/article-lookup/doi/10.1182/blood.v98.6.1721 Dearden et al. 2001] | |[https://ashpublications.org/blood/article-lookup/doi/10.1182/blood.v98.6.1721 Dearden et al. 2001] | ||
Line 45: | Line 45: | ||
====Chemotherapy==== | ====Chemotherapy==== | ||
− | * [[Alemtuzumab (Campath)]] | + | * [[Alemtuzumab (Campath)]] as follows: |
+ | **First week: 3 mg IV once on day 1, then 10 mg IV once on day 2, then 30 mg IV once on day 3 | ||
+ | **Subsequent weeks: 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. [https://ashpublications.org/blood/article-lookup/doi/10.1182/blood.v98.6.1721 link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/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://ashpublications.org/blood/article-lookup/doi/10.1182/blood-2011-08-372854 link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/21948296 PubMed] | ||
+ | |||
+ | ==Pentostatin & Alemtuzumab {{#subobject:aacb018|Regimen=1}}== | ||
+ | {| class="wikitable" style="float:right; margin-left: 5px;" | ||
+ | |- | ||
+ | |[[#top|back to top]] | ||
+ | |} | ||
+ | ===Regimen {{#subobject:881cj3a|Variant=1}}=== | ||
{| class="wikitable" style="width: 50%; text-align:center;" | {| class="wikitable" style="width: 50%; text-align:center;" | ||
− | ! style="width: | + | !style="width: 33%"|Study |
− | ! style="width: | + | !style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]] |
− | !Efficacy | + | !style="width: 33%"|[[Levels_of_Evidence#Efficacy|Efficacy]] |
|- | |- | ||
− | + | |[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4881363/ Ravandi et al. 2009 (MDACC 2004-0408)] | |
− | + | | style="background-color:#91cf61" |Non-randomized | |
− | + | |ORR: 69%, CR: 62% | |
− | |} | + | |} |
====Chemotherapy==== | ====Chemotherapy==== | ||
− | *[[Alemtuzumab (Campath)]] First week: 3 mg IV on | + | *[[Alemtuzumab (Campath)]] as follows: |
− | *[[Pentostatin (Nipent)]] 4 mg/m<sup>2</sup> IV | + | **First week: 3 mg IV once on day 1, then 10 mg IV once on day 2, then 30 mg IV once on day 3 |
+ | **Subsequent weeks: 30 mg IV three times weekly | ||
+ | *[[Pentostatin (Nipent)]] as follows: | ||
+ | **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 | ||
+ | |||
+ | '''Continued until achievement of CR or best response or for up to a total of 3 months (total of 14 doses of pentostatin)''' | ||
===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://ascopubs.org/doi/full/10.1200/JCO.2009.22.6688 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4881363/ link to PMC article] [https://www.ncbi.nlm.nih.gov/pubmed/19805674 PubMed] | ||
− | # | + | =Relapsed or refractory, salvage therapy= |
− | + | ==Bendamustine monotherapy {{#subobject:a1kc88|Regimen=1}}== | |
− | # | + | {| class="wikitable" style="float:right; margin-left: 5px;" |
− | + | |- | |
− | + | |[[#top|back to top]] | |
− | + | |} | |
− | + | ===Regimen {{#subobject:90ucj3a|Variant=1}}=== | |
− | |||
− | |||
{| class="wikitable" style="width: 50%; text-align:center;" | {| class="wikitable" style="width: 50%; text-align:center;" | ||
! style="width: 25%" |Study | ! style="width: 25%" |Study | ||
! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]] | ! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]] | ||
− | |||
|- | |- | ||
− | + | |[https://onlinelibrary.wiley.com/doi/full/10.1111/bjh.13175 Herbaux et al. 2014] | |
− | + | | style="background-color:#ffffbe" |Retrospective | |
− | + | |} | |
− | |} | ||
====Chemotherapy==== | ====Chemotherapy==== | ||
+ | * [[Bendamustine (Treanda)|Bendamustine]] 70 to 120 mg/m<sup>2</sup> IV once per day on days 1 & 2 | ||
− | + | '''21-day cycle for 6 cycles''' | |
− | |||
− | + | ===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://onlinelibrary.wiley.com/doi/full/10.1111/bjh.13175 link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/25316212 PubMed] |
− | + | ==Pentostatin & Alemtuzumab {{#subobject:a1kb018|Regimen=1}}== | |
− | + | {| class="wikitable" style="float:right; margin-left: 5px;" | |
− | Regimen | + | |- |
+ | |[[#top|back to top]] | ||
+ | |} | ||
+ | ===Regimen {{#subobject:991cj3a|Variant=1}}=== | ||
{| class="wikitable" style="width: 50%; text-align:center;" | {| class="wikitable" style="width: 50%; text-align:center;" | ||
− | ! style="width: | + | !style="width: 33%"|Study |
− | ! style="width: | + | !style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]] |
+ | !style="width: 33%"|[[Levels_of_Evidence#Efficacy|Efficacy]] | ||
|- | |- | ||
− | + | |[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4881363/ Ravandi et al. 2009 (MDACC 2004-0408)] | |
− | + | | style="background-color:#91cf61" |Non-randomized | |
+ | |ORR: 69%, CR: 62% | ||
|} | |} | ||
+ | ====Chemotherapy==== | ||
− | * [[ | + | *[[Alemtuzumab (Campath)]] as follows: |
+ | **First week: 3 mg IV once on day 1, then 10 mg IV once on day 2, then 30 mg IV once on day 3 | ||
+ | **Subsequent weeks: 30 mg IV three times weekly | ||
+ | *[[Pentostatin (Nipent)]] as follows: | ||
+ | **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 | ||
− | ''' | + | '''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. [https://ascopubs.org/doi/full/10.1200/JCO.2009.22.6688 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4881363/ link to PMC article] [https://www.ncbi.nlm.nih.gov/pubmed/19805674 PubMed] | ||
− | + | ==Ibrutinib & Venetoclax {{#subobject:a1uh18|Regimen=1}}== | |
+ | {| class="wikitable" style="float:right; margin-left: 5px;" | ||
+ | |- | ||
+ | |[[#top|back to top]] | ||
+ | |} | ||
+ | ===Regimen {{#subobject:991ica|Variant=1}}=== | ||
+ | {| class="wikitable" style="width: 50%; text-align:center;" | ||
+ | !style="width: 50%"|Study | ||
+ | !style="width: 50%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | |- | ||
+ | |[https://ashpublications.org/blood/article/134/Supplement_1/3965/424160/Combination-of-Venetoclax-and-Ibrutinib-Increases Kornauth et al. 2019] | ||
+ | | style="background-color:#91cf61" |Non-randomized | ||
+ | |- | ||
+ | |} | ||
+ | ====Chemotherapy==== | ||
+ | * [[Ibrutinib (Imbruvica)|Ibrutinib]] 420 mg PO once per day | ||
+ | * [[Venetoclax (Venclexta)|Venetoclax]] 400 to 600 mg PO once per day | ||
− | + | '''Continued indefinitely''' | |
− | + | ===References=== | |
− | |||
− | |||
− | |||
− | # 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 | + | # '''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= | |
'''[[Allogeneic HSCT]]''' evaluation suggested in eligible patients. | '''[[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. [https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2141.2010.08134.x link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/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://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2141.2010.08134.x link to original article] [https://www.ncbi.nlm.nih.gov/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://www.sciencedirect.com/science/article/pii/S1083879109005813 link to SD article] [https://www.ncbi.nlm.nih.gov/pubmed/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://www.sciencedirect.com/science/article/pii/S1083879109005813 | + | # '''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://www.ncbi.nlm.nih.gov/pubmed/22116553 PubMed] |
− | # 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://www.ncbi.nlm.nih.gov/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 01:38, 8 January 2020
Section editor | |
---|---|
Bhagirathbhai Dholaria, MBBS Vanderbilt University Nashville, TN |
5 regimens on this page
5 variants on this page
|
Guidelines
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
back to top |
Regimen
Study | Evidence | Efficacy |
---|---|---|
Dearden et al. 2001 | Non-randomized | ORR: 76%, CR: 60% |
Dearden et al. 2011 | Non-randomized | ORR: 91%, CR: 81% |
Chemotherapy
- Alemtuzumab (Campath) as follows:
- First week: 3 mg IV once on day 1, then 10 mg IV once on day 2, then 30 mg IV once on day 3
- Subsequent weeks: 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
back to top |
Regimen
Study | Evidence | Efficacy |
---|---|---|
Ravandi et al. 2009 (MDACC 2004-0408) | Non-randomized | ORR: 69%, CR: 62% |
Chemotherapy
- Alemtuzumab (Campath) as follows:
- First week: 3 mg IV once on day 1, then 10 mg IV once on day 2, then 30 mg IV once on day 3
- Subsequent weeks: 30 mg IV three times weekly
- 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
back to top |
Regimen
Study | Evidence |
---|---|
Herbaux et al. 2014 | Retrospective |
Chemotherapy
- Bendamustine 70 to 120 mg/m2 IV once per day on days 1 & 2
21-day cycle for 6 cycles
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
back to top |
Regimen
Study | Evidence | Efficacy |
---|---|---|
Ravandi et al. 2009 (MDACC 2004-0408) | Non-randomized | ORR: 69%, CR: 62% |
Chemotherapy
- Alemtuzumab (Campath) as follows:
- First week: 3 mg IV once on day 1, then 10 mg IV once on day 2, then 30 mg IV once on day 3
- Subsequent weeks: 30 mg IV three times weekly
- 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
back to top |
Regimen
Study | Evidence |
---|---|
Kornauth et al. 2019 | Non-randomized |
Chemotherapy
- 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 SD 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