I have a young patient with hepatosplenic T-cell lymphoma. He had 4 cycles of CHOEP, he progressed; then he had 4 cycles of SMILE with PEG-Asparaginase, and he progressed. He received 1 cycle of CODOX-M and 1 cycle of IVAC. Unfortunately he has progressed again. His performance status is excellent, he does not have comorbidities and he has a fully matched sibling. What chemotherapy regimen do you suggest before taking him to a myeloablative allogeneic hematopoietic stem cell transplantation?
Dear Mojtaba Akhtari,
Based on the literature you could consult these two guys:
Matthew A. Lunning: gro.ccksm@mgninnul;
Steven Horwitz: gro.ccksm@sztiwroh
Regarding the above patient I wonder if anybody has experience with Alemtuzumab (Campath).
Why not the conventional pre conditioning regimens like ICE, DHAP or GDP? I'd suggest GDP for two reasons.. one, it's better tolerated than most others.. And two, there's a decent amount of literature on it and it seems to be as good as any of the others in the final results.. Not much data on campath as a preTx regimen I think.. Hasn't been approved for that either.
Although these guys here on RG have used Alemtuzumab (Campath-1H) as a first-line treatment it may be worth talking to them.
Alemtuzumab (Campath-1H) and CHOP chemotherapy as first-line treatment of
peripheral T-cell lymphoma: results of a GITIL (Gruppo Italiano Terapie
Innovative nei Linfomi) prospective multicenter trial
Andrea Gallamini, Francesco Zaja, Caterina Patti, Atto Billio, Maria Rosaria Specchia
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