Prolonged chemotherapy for angioimmunoblastic T-cell lymphoma

N.G. Chernova1, Yu.E. Vinogradova2, Yu.V. Sidorova1, I.B. Kaplanskaya1, E.A. Gilyazitdinova1, L.G. Gorenkova1, D.S. Marin1, A.M. Kremenetskaya1, A.I. Vorobyev1, and S.K. Kravchenko1

1 Hematology Research Center, RF MH, Moscow, Russian Federation

2 I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation


Introduction: Current СНОР-like therapy for angioimmunoblastic T-cell lymphoma demonstrates unsatisfactory results with respect to the achievement of complete remission. It indicates the need in the search for new approaches to therapy of angioimmunoblastic T-cell lymphoma.

Objective: To define the rational approaches to the diagnosis and treatment of angioimmunoblastic T-cell lymphoma (AITL).

Materials and methods: Within the period from 2002 to 2012, we followed-up 15 patients with angioimmunoblastic T-cell lymphoma, with median age of 61 years (range 29–77) and the male/female ratio of 11/4. All patients had stage IV disease; the bone marrow, lungs, spleen, and skin were involved in 14 (93 %), 9 (60 %), 12 (80 %), and 6 (40 %) patients, respectively.

Results: We used prolonged chemotherapy GMALL 2002 and ALL-2009 regimens for treatment of angioimmunoblastic T-cell lymphoma (11 patients). Complete remission was achieved in 55 % of cases with median follow up of 33 mouths.

Conclusion: The usage of short-term chemotherapy programs (CHOP-like) for treatment of angioimmunoblastic T-cell lymphoma doesn’t seem to give good results. Administration of prolonged chemotherapy is more appropriate and allows achieving remission of the disease.

Keywords: angioimmunoblastic T-cell lymphoma, prolonged chemotherapy.

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  1. Swerdlow S.H., Campo E., Harris N.L. et al. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. Lyon: IARC Press, 2008.
  2. Виноградова Ю.Е., Зингерман Б.В. Нозологические формы и вы- живаемость пациентов с Т- и NK-клеточными лимфатическими опухолями, наблюдавшихся в ГНЦ в течение 10 лет. Клин. онкогематол. 2011; 4(3): 201–27. [Vinogradova Yu.Ye., Zingerman B.V. Nosological forms and survival of patients with T- and NK-cell lymphatic tumors, followed-up at HRC for 10 years. Klin. onkogematol. 2011; 4(3): 201–27. (In Russ.)].
  3. Frizzera G., Moran E.M., Rappaport H. Angio-immunoblastic lymphadenopathy: diagnosis and clinical course. Am. J. Med. 1975; 59: 803–18.
  4. Dogan A., Attygalle A.D., Kyriakou C. Angioimunoblastic T-cell lymphoma. Br. J. Haematol. 2003; 121: 681–91.
  5. Weiss L.M., Jaffe E.S., Liu X.F. et al. Detection and localization of Epstein-Barr viral genomes in angioimmunoblastic lymphadenopathy and angioimmunoblastic lymphadenopathy-like lymphoma. Blood 1992; 79: 1789–95.
  6. Dupuis J., Boye K., Martin N. et al. Expression of CXCL13 by neoplastic cells in angioimmunoblastic T-cell lymphoma (AITL). A new diagnostic marker providing evidence that AITL derives from follicular helper T-cells. Am. J. Surg. Pathol. 2006; 30: 490–4.
  7. Attygalle A., Al Jehani R., Diss T.C. et al. Neoplastic T cells in angioimmunoblastic T-cell lymphoma express CD10. Blood 2002; 99: 627–33.
  8. de Leval L., Rickman D.S., Thielen C. et al. The gene expression profile of nodal peripheral T-cell lymphoma demonstrates a molecular link between angioimmunoblastic T-cell lymphoma (AITL) and follicular helper T cells (TFH). Blood 2007; 109: 4952–63.
  9. Yu H., Shahsafaei A., Dorfman D. Germinal-center T-helper cell markers PD-1 and CXCL13 are both expressed by neoplastic cells in angioimmunoblastic T-cell lymphoma. Am. J. Clin. Pathol. 2009; 131: 33–41.
  10. Miyoshi H., Sato K., Niino D. et al. Clinicopathologic analysis of peripheral T-cell lymphoma, follicular variant, and comparison with angioimmunoblastic T-cell lymphoma: Bcl-6 expression might affect progression between these disorders. Am. J. Clin. Pathol. 2012; 137(6): 879–89.
  11. Стефанов Д.Н., Ковригина А.М., Поддубная А.М. Новая концепция происхождения ангиоиммунобластной Т-клеточной лимфомы: от молеку- лярной биологии к терапии. Бюл. СО РАМН 2011; 31(2): 14–9. [Stefanov D.N., Kovrigina A.M., Poddubnaya A.M. New concept of origin of angioimmunoblastic T-cell lymphoma: from molecular biology to therapy. Byul. SO RAMN 2011; 31(2): 14–9. (In Russ.)].
  12. Wang S.H., Wang Q.S., Sun L. et al. Clinical analysis of 12 patients with angioimmunoblastic T cell lymphoma. Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2010; 18(5): 1208–10.
  13. Lin H.N., Liu C.Y., Hong Y.C. et al. Clinical features and prognostic factors of angioimmunoblastic T-cell lymphoma in Taiwan: a single-institution experience. Leuk. Lymphoma 2010; 51(12): 2208–14.
  14. Mourand N., Mounier N., Briere J. et al. Clinical, biologic and pathologic features in 157 patients with angioimmunoblastic T-cell lymphoma treated within the Groupe d’Etude des Lymphomes de l’Adulte (GELA) trials. Blood 2008; 111: 4463–70.
  15. Siegert W., Agthe A., Griesser H. et al. Treatment of angioimmunoblastic lymphadenopathy (AILD)-type T-cell lymphoma using prednisone with or without the COP-BLAM/IMVP-16 regimen. A multicenter study. Kiel Lymphoma Study Group. Ann. Intern. Med. 1992; 117(5): 364–70.
  16. Nickelsen M., Ziepert M., Zeynalova S. et al. High-dose CHOP plus etoposide (MegaCHOEP) in T-cell lymphoma: a comparative analysis of patients treated within trials of the German High-Grade Non-Hodgkin Lymphoma Study Group (DSHNHL). Ann. Oncol. 2009; 20(12): 1977–84.
  17. Karakas T., Bergmann L., Stutte H.J. et al. Peripheral T-cell lymphomas respond well to vincristine, adriamycin, cyclophosphamide, prednisone and etoposide (VACPE) and have a similar outcome as high-grade B-cell lymphomas. Leuk. Lymphoma 1996; 24(1–2): 121–9.
  18. Kyriakou C., Canals C., Goldstone A. et al. High-dose therapy and autologous stem-cell transplantation in angioimmunoblastic lymphoma: complete remission at transplantation is the major determinant of Outcome-Lymphoma Working Party of the European Group for Blood and Marrow Transplantation. J. Clin. Oncol. 2008; 26(2): 218–24.
  19. Delfau-Larue M.-H., de Leval L., Joly B. et al. Targeting intratumoral B cells with rituximab in addition to CHOP in angioimmunoblastic T-cell lymphoma. A clinicobiological study of the GELA. Haematologica 2012; 97(10): 1594–602.
  20. Hoelzer D., Gokbuget N., Digel W. et al. Outcome of adult patients with Tlymphoblastic lymphoma treated according to protocols for acute lymphoblastic leukemia. Blood 2002; 99(12): 4379–85.
  21. Паровичникова Е.Н., Клясова Г.А., Исаев В.Г. и др. Первые итоги терапии Ph’-негативных острых лимфобластных лейкозов взрослых по протоколу научно-исследовательской группы гематологических центров России ОЛЛ-2009. Тер. арх. 2008; 83(7): 11–7. [Parovichnikova Ye.N., Klyasova G.A., Isayev V.G. et al. Initial outcomes of therapy for Ph-negative acute lymphoblastic leukemias in adults in accordance to protocol of OLL-2009 investigator group from hematological centers in Russia. Ter. arkh. 2008; 83(7): 11–7. (In Russ.)].
  22. Gottardi M., Danesin C., Canal F. et al. Complete remission induced by thalidomide in a case of angioimmunoblastic T-cell lymphoma refractory to autologous stem cell transplantation. Leuk. Lymphoma 2008; 49(9): 1836–8.
  23. Чернова Н.Г., Виноградова Ю.Е., Гилязитдинова Е.А. и др. Проблемы диагностики и лечения ангиоиммунобластной Т-клеточной лимфомы. Гематол. и трансфузиол. 2012; 3: 87. [Chernova N.G., Vinogradova Yu.Ye., Gilyazitdinova Ye.A. et al. Problems of diagnosis and treatment of angioimmunoblastic T-cell lymphoma. Gematol. i transfuziol. 2012; 3: 87. (In Russ.)].