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 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 an allogeneic hematopoietic stem cell transplantation?
Dear Palma,
Thank you for your reply. My patient has had progression after undergoing 2 lines of chemotherapy in the past. What are your thoughts on giving him CODOX-M and IVAC, then taking him to an allogeneic hematopoietic stem cell transplantation?
To Palma: I am not sure if EPOCH can be a good regimen for my patient since he progressed while he was getting CHOEP, and they are very similar regimens.
Regarding the CODOX-M/IVAC regimen there is track record for it in patients with Burkitt's lymphoma.
To Stefan: Thank you for your reply. The HOVON 70 protocol looks reasonable; thank you for sharing it with us.
Whatever is used, if he is able to get into remission he should undergo allogenic transplant urgently.
Ara-c based regimen Like DHAP may be a consideration. With that view IVAC is a better option
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