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Peripheral T-cell lymphoma (PTCL) is a type of non-Hodgkin’s lymphoma (NHL), which is relatively rare in European and American countries, accounting for only about 6%-10% of all NHL cases; but it is more common in Asian countries, accounting for about 21.
4% of all lymphomas.
On April 16-18, 2021, the First National Lymphocytic Disease Academic Conference of the Chinese Medical Association and the 2021 International Lymphoma Latest Progress Symposium were successfully held in Chengdu.
Well-known experts at home and abroad are specially invited to give wonderful speeches on topics related to lymphocytic diseases .
On this occasion, Yimaitong invited Professor Bai Ou from Bethune First Hospital of Jilin University to be interviewed to share the research progress of PTCL.
Yimaitong: In recent years, major breakthroughs have been made in the molecular typing of peripheral T-cell lymphoma.
Could you please introduce the significance of the determination of molecular classification in the diagnosis and treatment of peripheral T-cell lymphoma? Professor Bai Ou’s molecular classification of lymphoma has a certain guiding role in the classification of lymphoma molecular subtypes and the selection of treatment options, especially in PTCL, which can further judge follicular helper T cell lymphoma and angioimmunoblastic T Cell lymphoma and other subtypes.
In addition, most of the current pathology centers also conduct surface marker detection for T-cell lymphoma, such as determining the expression level of CD30, which can better complement the pathological classification and guide the precise selection of subsequent targeted therapies.
Yimaitong: Could you please tell us about the recent treatment of peripheral T-cell lymphoma, especially the first-line treatment which is worth paying attention to? Professor Bai Ou has more than 30 kinds of PTCL, the more important subtypes include PTCL-unspecified type, angioimmunoblastic T cell lymphoma, anaplastic large cell lymphoma (including ALK positive and negative), and NK/T cell Lymphoma, these types of lymphoma account for more than 70% of all PTCL and are the focus of research.
Among the above types of PTCL, the application of targeted drugs is currently an important clinical development, which mainly includes specific monoclonal antibodies that bind to tumor cell surface antigens and histone deacetylase inhibitors (HDACi).
Specific monoclonal antibodies that bind to surface antigens include CD30 monoclonal antibody vebutuximab (BV), CD52 monoclonal antibody alemtuzumab (alemtuzumab), and pralatrexate, a drug that inhibits the synthesis of folic acid.
At present, the NCCN guidelines recommend that patients with CD30-positive lymphoma in the first to second line be combined with BV therapy on the basis of chemotherapy.
The results of the ECHELON study showed that compared with the standard CHOP regimen, chemotherapy combined with BV regimen improved the overall survival (OS), progression-free survival (PFS), complete remission (CR) rate and partial remission (PR) rate of patients.
Reduce the risk of disease progression and death.
HDACi includes romidepsin and chidamide.
The First Bethune Hospital of Jilin University is currently exploring the efficacy of the first-line CHOP/CHOP-like regimen combined with Chidamide and subsequent use of Chidamide for maintenance treatment.
It is expected that the clinical efficacy of some PTCL patients can be improved.
Yimaitong: Whether patients with peripheral T-cell lymphoma need hematopoietic stem cell transplantation after the first-line treatment is relieved, and whether to choose autologous transplantation or allogeneic transplantation is still controversial.
What is your opinion? Professor Bai Ou still has many controversies on this issue.
In the past, after induction therapy, autologous hematopoietic stem cell transplantation (ASCT) was recommended for patients younger than 65 years old and in a suitable physical condition.
So in the era of targeted therapy, should one choose hematopoietic stem cell transplantation or targeted therapy? There are still no head-to-head clinical studies that give clear evidence.
However, studies have shown that hematopoietic stem cell transplantation can benefit some high-risk patients; some studies have also shown that combined targeted therapy can also benefit some patients.
Therefore, there is no definite conclusion at present, and all centers are actively exploring.
In addition, should hematopoietic stem cell transplantation choose ASCT or allogeneic hematopoietic stem cell transplantation (allo-HSCT)? Studies have shown that in patients with diffuse large B-cell lymphoma (DLBCL) and PTCL patients, the efficacy of allo-HSCT is not significantly better than ASCT.
In addition, allo-HSCT is a treatment method suitable for high-tech and extremely high-risk patients.
Therefore, in the clinic, doctors are still required to make individualized treatment options according to the patient's condition, and in the clinic, a larger-scale clinical study is also needed.
Explore further.
Professor Bai Ou, Deputy Director, Department of Hematology, Bethune First Hospital, Jilin University, Head of the Lymphoma Specialist Alliance, Bethune First Hospital, Jilin University, Member of the Lymphocytic Disease Group of the 11th Committee of the Chinese Medical Association Hematology Branch, Chinese Society of Clinical Oncology (CSCO) Member of the Standing Committee of the Lymphoma Professional Committee of the Chinese Anti-Cancer Association CSCO Member of the Standing Committee of the Chinese Anti-Lymphoma Alliance (UCLI) Member of the Standing Committee of the 5th Clinical Chemotherapy Committee of the Chinese Anti-Cancer Association Member of the Standing Committee of the First Committee of the Chinese Society of Geriatrics Hematology Branch Member of the Standing Committee of the Oncology Branch of the International Exchange Promotion Association CSCO Member of the Chinese Anti-Leukemia Alliance (UCLI) stamp "Read the original text", we make progress together
4% of all lymphomas.
On April 16-18, 2021, the First National Lymphocytic Disease Academic Conference of the Chinese Medical Association and the 2021 International Lymphoma Latest Progress Symposium were successfully held in Chengdu.
Well-known experts at home and abroad are specially invited to give wonderful speeches on topics related to lymphocytic diseases .
On this occasion, Yimaitong invited Professor Bai Ou from Bethune First Hospital of Jilin University to be interviewed to share the research progress of PTCL.
Yimaitong: In recent years, major breakthroughs have been made in the molecular typing of peripheral T-cell lymphoma.
Could you please introduce the significance of the determination of molecular classification in the diagnosis and treatment of peripheral T-cell lymphoma? Professor Bai Ou’s molecular classification of lymphoma has a certain guiding role in the classification of lymphoma molecular subtypes and the selection of treatment options, especially in PTCL, which can further judge follicular helper T cell lymphoma and angioimmunoblastic T Cell lymphoma and other subtypes.
In addition, most of the current pathology centers also conduct surface marker detection for T-cell lymphoma, such as determining the expression level of CD30, which can better complement the pathological classification and guide the precise selection of subsequent targeted therapies.
Yimaitong: Could you please tell us about the recent treatment of peripheral T-cell lymphoma, especially the first-line treatment which is worth paying attention to? Professor Bai Ou has more than 30 kinds of PTCL, the more important subtypes include PTCL-unspecified type, angioimmunoblastic T cell lymphoma, anaplastic large cell lymphoma (including ALK positive and negative), and NK/T cell Lymphoma, these types of lymphoma account for more than 70% of all PTCL and are the focus of research.
Among the above types of PTCL, the application of targeted drugs is currently an important clinical development, which mainly includes specific monoclonal antibodies that bind to tumor cell surface antigens and histone deacetylase inhibitors (HDACi).
Specific monoclonal antibodies that bind to surface antigens include CD30 monoclonal antibody vebutuximab (BV), CD52 monoclonal antibody alemtuzumab (alemtuzumab), and pralatrexate, a drug that inhibits the synthesis of folic acid.
At present, the NCCN guidelines recommend that patients with CD30-positive lymphoma in the first to second line be combined with BV therapy on the basis of chemotherapy.
The results of the ECHELON study showed that compared with the standard CHOP regimen, chemotherapy combined with BV regimen improved the overall survival (OS), progression-free survival (PFS), complete remission (CR) rate and partial remission (PR) rate of patients.
Reduce the risk of disease progression and death.
HDACi includes romidepsin and chidamide.
The First Bethune Hospital of Jilin University is currently exploring the efficacy of the first-line CHOP/CHOP-like regimen combined with Chidamide and subsequent use of Chidamide for maintenance treatment.
It is expected that the clinical efficacy of some PTCL patients can be improved.
Yimaitong: Whether patients with peripheral T-cell lymphoma need hematopoietic stem cell transplantation after the first-line treatment is relieved, and whether to choose autologous transplantation or allogeneic transplantation is still controversial.
What is your opinion? Professor Bai Ou still has many controversies on this issue.
In the past, after induction therapy, autologous hematopoietic stem cell transplantation (ASCT) was recommended for patients younger than 65 years old and in a suitable physical condition.
So in the era of targeted therapy, should one choose hematopoietic stem cell transplantation or targeted therapy? There are still no head-to-head clinical studies that give clear evidence.
However, studies have shown that hematopoietic stem cell transplantation can benefit some high-risk patients; some studies have also shown that combined targeted therapy can also benefit some patients.
Therefore, there is no definite conclusion at present, and all centers are actively exploring.
In addition, should hematopoietic stem cell transplantation choose ASCT or allogeneic hematopoietic stem cell transplantation (allo-HSCT)? Studies have shown that in patients with diffuse large B-cell lymphoma (DLBCL) and PTCL patients, the efficacy of allo-HSCT is not significantly better than ASCT.
In addition, allo-HSCT is a treatment method suitable for high-tech and extremely high-risk patients.
Therefore, in the clinic, doctors are still required to make individualized treatment options according to the patient's condition, and in the clinic, a larger-scale clinical study is also needed.
Explore further.
Professor Bai Ou, Deputy Director, Department of Hematology, Bethune First Hospital, Jilin University, Head of the Lymphoma Specialist Alliance, Bethune First Hospital, Jilin University, Member of the Lymphocytic Disease Group of the 11th Committee of the Chinese Medical Association Hematology Branch, Chinese Society of Clinical Oncology (CSCO) Member of the Standing Committee of the Lymphoma Professional Committee of the Chinese Anti-Cancer Association CSCO Member of the Standing Committee of the Chinese Anti-Lymphoma Alliance (UCLI) Member of the Standing Committee of the 5th Clinical Chemotherapy Committee of the Chinese Anti-Cancer Association Member of the Standing Committee of the First Committee of the Chinese Society of Geriatrics Hematology Branch Member of the Standing Committee of the Oncology Branch of the International Exchange Promotion Association CSCO Member of the Chinese Anti-Leukemia Alliance (UCLI) stamp "Read the original text", we make progress together
