外周T细胞淋巴瘤的治疗进展_West China Medical Journal

Authors：

 朱小凤 ,  李晓明

泸州医学院附属医院血液内科（四川泸州，646000）;

Corresponding author：

李晓明, Email: lxm6358@21cn.com

Keywords：

T细胞淋巴瘤; 研究现状; 治疗进展

DOI：

10.7507/1002-0179.20140199

Video：

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T细胞淋巴瘤（TCL）是来源于T淋巴细胞的一类恶性淋巴肿瘤，目前尚无统一的最佳治疗方法。虽近年有新的治疗药物，但都只基于少量的病例或小规模的Ⅱ期临床试验。美国国立卫生研究院对于非皮肤型外周TCL的原则为一线治疗方案首选临床试验。且一线巩固方案除低危患者外，应考虑行大剂量化学治疗（化疗）联合造血干细胞移植。另外由于间变性淋巴瘤激酶基因阳性的间变大细胞淋巴瘤预后较好，对处于完全缓解期者无需行干细胞移植。二线治疗方案中，对于耐受大剂量化疗的患者首选临床试验。对于不能耐受大剂量化疗的患者首先考虑参加临床试验，其次使用新药（如阿仑单抗、硼替佐米、地尼白介索、吉西他滨等）及放射治疗，或根据原癌基因或抑癌基因进行治疗。现就其治疗进展作一综述。

Citation： 朱小凤, 李晓明. 外周T细胞淋巴瘤的治疗进展. West China Medical Journal, 2014, 29(4): 660-664. doi: 10.7507/1002-0179.20140199 Copy

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2.	Jaffe ES. Harris NL, Stein H. World Health Organization classification of tumours:pathology and genetics of tumours of the haemelopoietic and lymphoid tissues[M]. Lyon:IARC Press, 2001.
3.	Savage KJ, Ferreri AJ, Zinzani PL, et al. Peripheral T-cell lymphoma-not otherwise specified[J]. Crit Rev Oncol Hematol, 2011, 79(3):321-329.
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6.	Gisselbrecht C, Lepage E, Molina T, et al. Shortened first-line high-dose chemotherapy for patients with poor-prognosis aggressive lymphoma[J]. J Clin Oncol, 2002, 20(10):2472-2479.
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8.	Song KW, Mollee P, Keating A, et al. Autologous stem cell transplant for relapsed and refractory peripheral T-cell lymphoma:variable outcome according to pathological subtype[J]. Br J Haematol, 2003, 120(6):978-985.
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12.	Majhail NS. Burns U. Hematopoietic stem cell transplantation in the treatment of pephend T-cell lymphomas[J]. Curr Hematol Rep, 2005, 4(4):252-259.
13.	Zinzani PL, Venturini F, Stefoni V, et al. Gemcitabine as single agent in pretreated T-cell lymphoma patients:evaluation of the long-term outcome[J]. Ann Oncol, 2010, 21(4):860-863.
14.	Arkenau HT, Chong G, Cunningham D, et al. Gemcitabine, cisplatin and methylprednisolone for the treatment of patients with peripheral T-cell lymphoma:the Royal Marsden Hospital experience[J]. Haematologica, 2007, 92(2):271-272.
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17.	D'Amore F, Radford J, Relander T, et al. PhaseⅡ trial of zanolimumab (HuMax-CD4) in relapsed or refractory non-cutaneous peripheral T cell lymphoma[J]. Br J Haematol, 2010, 150(5):565-573.
18.	O'Connor OA, Hamlin PA, Gerecitano J, et al. Pralatrexate (PDX) produces durable complete remissions in patients with chemotherapy resistant precursor and peripheral T-cell lymphoma. Results of the MSKCC PhaseⅠ/Ⅱexperience[J]. Blood, 2006, 108(11):122A-123A.
19.	Mould DR, Sweeney K, Dufull SB, et al. Apopulation pharmacokinenetic and pharmacodynamic evaluation of pralatrexate in patients with relapsed or refractory non-Hodhkin's or Hodgkin's lymphoma[J]. Clin Pharmacol Ther, 2009, 86(2):190-196.
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23.	Olsen EA, Kim YH, Kuzel TM, et al. PhaseⅠb multicenter trail of vorinostat in patients with persistent, progressive,or treatment refractory cutaneous T-cell Lymphoma[J]. J Clin Oncol, 2007, 25(21):3109-3115.
24.	Bates SE, Zhan Z, Steadman K, et al. Laboratory correlates for a phaseⅠ trail of romidepsin in cutaneous and peripaheral T-cell lymphoma[J]. Br J Haematol, 2010, 148(2):256-267.
25.	Piekarz RL, Frye R, Turner M, et al. Responses and molecular markers in patients with peripheral T-cell lymphorna treated on a phaseⅠ trial of depsipeptide[J]. J Clin Oncol, 2005, 23(16S):3061.
26.	Zinzani PL, Musuraca G, Tani M, et al. PhaseⅠ trial of proteasome inhibitor bortezomib in patients with relapsed or refractory cutaneous T-cell lymphoma[J]. J Clin Oncol, 2007, 25(27):4293-4297.
27.	Yamamoto K, Utsunomiya A, Tobinai K, et al. Phase I study of KW-0761, a defucosylated humanized anti-CCR4 antibody, in relapsed patients with adult T-cell leukemia-lymphoma and peripheral T-cell lymphoma[J]. J Clin Oncol, 2010, 28(9):1591-1598.
28.	O'Connor OA, Masszi T, Savage KJ, et al. Belinostat, a novel pan-histone deacetylase inhibitor (HDACi), in relapsed or refractory peripheral T-cell lymphoma (R/R PTCL):results from the BELIEF trial[J]. J Clin Oncol, 2013, 31(18S):8507.
29.	O'Brien SM, axton Df CM. PhaseⅠ study of obatoclax mesylate (GXl5-070) a small mo1ecule pan-bcl-2 family antagonist in patients with advanced chronic lymphocytic leukemia[J]. Blood, 2009, 113(2):299-305.
30.	朱军, 丁宁. 从机制阐述淋巴瘤治疗药进展[N]. 医师报, 2013-01-05(5).
31.	Bruns I, Fox F, Reinecke P, et al. Complete remission in a patient with relapsed angioimmunoblastic T-cell lymphoma following treatment with bevacizumab[J]. Leukemia, 2005, 19(11):1993-1995.
32.	Foss FM, Zinzani PL, Vose JM, et al. Peripheral T-cell lymphoma[J]. Blood, 2011, 117(25):6756-6767.

1. Savage KJ, Chhanabhai M, Gascoyne RD, et al. Characterization of peripheral T-cell lymphomas in a single North American institution by the WHO lassification[J]. Ann Oncol, 2004, 15(10):1467-1475.
2. Jaffe ES. Harris NL, Stein H. World Health Organization classification of tumours:pathology and genetics of tumours of the haemelopoietic and lymphoid tissues[M]. Lyon:IARC Press, 2001.
3. Savage KJ, Ferreri AJ, Zinzani PL, et al. Peripheral T-cell lymphoma-not otherwise specified[J]. Crit Rev Oncol Hematol, 2011, 79(3):321-329.
4. Delmer A, Mounier N, Gaulard P, et al. Intensified induction therapy with etoposide (VP16) and high-dose cytarabine (Ara-C) in patients aged less than 60 years with peripheral T cell/NK-cell lymphoma:preliminary results of the GELA phase Ⅱ study LNH98T7[J]. J Clin Oncol, 2003, 22(Suppl):591.
5. Schmitz N, Trümper L, Ziepert M, et al. Treatment and prognosis of mature T-cell and NK-cell lymphoma:an analysis of patients with T-cell lymphoma treated in studies of the German High-Grade Non-Hodgkin Lymphoma Study Group[J]. Blood, 2010, 116(18):3418-3425.
6. Gisselbrecht C, Lepage E, Molina T, et al. Shortened first-line high-dose chemotherapy for patients with poor-prognosis aggressive lymphoma[J]. J Clin Oncol, 2002, 20(10):2472-2479.
7. Rodríguez J, Caballero MD, Gutiérrez A, et al. High dose chemotherapy and atuologous stem cell transplantation in peripheral T-cell lymphoma:the GEL-TAMO experience[J]. Ann Oncol, 2003, 14(12):1768-1775.
8. Song KW, Mollee P, Keating A, et al. Autologous stem cell transplant for relapsed and refractory peripheral T-cell lymphoma:variable outcome according to pathological subtype[J]. Br J Haematol, 2003, 120(6):978-985.
9. Rodríguez J, Conde E, Gutiérrez A, et al. The adjusted International Prognostic Index and beta-2-microglubulin predict the outcome after autologous stem cell transplantation in relapsing/refractory peripheral T-cell lymphoma[J]. Haematolngica, 2007, 92(8):1067-1074.
10. 安刚, 齐元军, 邱录贵. 外周T细胞淋巴瘤的治疗进展[J]. 中华血液学杂志, 2008, 29(10):719-720.
11. Corradini P, Dodero A, Zallio F, et al. Graft-versus-lymphoma effect in relapsed peripheral T-cell non-Hodgkin's lymphomas after reduced-intensity conditioning followed by allogeneic transplantation of hematopeietic cells[J]. J Clin One01, 2004, 22(11):2172-2176.
12. Majhail NS. Burns U. Hematopoietic stem cell transplantation in the treatment of pephend T-cell lymphomas[J]. Curr Hematol Rep, 2005, 4(4):252-259.
13. Zinzani PL, Venturini F, Stefoni V, et al. Gemcitabine as single agent in pretreated T-cell lymphoma patients:evaluation of the long-term outcome[J]. Ann Oncol, 2010, 21(4):860-863.
14. Arkenau HT, Chong G, Cunningham D, et al. Gemcitabine, cisplatin and methylprednisolone for the treatment of patients with peripheral T-cell lymphoma:the Royal Marsden Hospital experience[J]. Haematologica, 2007, 92(2):271-272.
15. Enblad G, Hagberg H, Erlanson M, et al. A pilot study of alemtuzumab (anti-CD52 monoclonal antibody) therapy for patients with relapsed or chemotherapy-refractory peripheral T-cell lymphomas[J]. Blood, 2004, 103(8):2920-2924.
16. Kluin-Nelemans HC, Coenen JL, Boers JE, et al. EBV-positive immunodefieiency lymphoma after alemtuzumab-CHOP therapy for peripheral T-cell Iymphoma[J]. Blood, 2008, 112(4):1039-1041.
17. D'Amore F, Radford J, Relander T, et al. PhaseⅡ trial of zanolimumab (HuMax-CD4) in relapsed or refractory non-cutaneous peripheral T cell lymphoma[J]. Br J Haematol, 2010, 150(5):565-573.
18. O'Connor OA, Hamlin PA, Gerecitano J, et al. Pralatrexate (PDX) produces durable complete remissions in patients with chemotherapy resistant precursor and peripheral T-cell lymphoma. Results of the MSKCC PhaseⅠ/Ⅱexperience[J]. Blood, 2006, 108(11):122A-123A.
19. Mould DR, Sweeney K, Dufull SB, et al. Apopulation pharmacokinenetic and pharmacodynamic evaluation of pralatrexate in patients with relapsed or refractory non-Hodhkin's or Hodgkin's lymphoma[J]. Clin Pharmacol Ther, 2009, 86(2):190-196.
20. Dang NH, Pro B, Hagemeister FB, et al. PhaseⅡ trail of denileukin diflitox for relapsed/refractory T-cell non-Hodgkin lymphoma[J]. Br J Haematol, 2007, 136(3):439-447.
21. Venugopal B, Evans TR. Developing histone deacetylase inhibitors as anti-cancer therapeutics[J]. Curr Med Chem, 2011, 18(11):1658-1671.
22. Cotto M, Cabanillas F, Tirado M, et al. Epigenetic therapy of lymphoma using histone deacetylase inhibitors[J]. Clin Transl Oncol, 2010, 12(6):401-409.
23. Olsen EA, Kim YH, Kuzel TM, et al. PhaseⅠb multicenter trail of vorinostat in patients with persistent, progressive,or treatment refractory cutaneous T-cell Lymphoma[J]. J Clin Oncol, 2007, 25(21):3109-3115.
24. Bates SE, Zhan Z, Steadman K, et al. Laboratory correlates for a phaseⅠ trail of romidepsin in cutaneous and peripaheral T-cell lymphoma[J]. Br J Haematol, 2010, 148(2):256-267.
25. Piekarz RL, Frye R, Turner M, et al. Responses and molecular markers in patients with peripheral T-cell lymphorna treated on a phaseⅠ trial of depsipeptide[J]. J Clin Oncol, 2005, 23(16S):3061.
26. Zinzani PL, Musuraca G, Tani M, et al. PhaseⅠ trial of proteasome inhibitor bortezomib in patients with relapsed or refractory cutaneous T-cell lymphoma[J]. J Clin Oncol, 2007, 25(27):4293-4297.
27. Yamamoto K, Utsunomiya A, Tobinai K, et al. Phase I study of KW-0761, a defucosylated humanized anti-CCR4 antibody, in relapsed patients with adult T-cell leukemia-lymphoma and peripheral T-cell lymphoma[J]. J Clin Oncol, 2010, 28(9):1591-1598.
28. O'Connor OA, Masszi T, Savage KJ, et al. Belinostat, a novel pan-histone deacetylase inhibitor (HDACi), in relapsed or refractory peripheral T-cell lymphoma (R/R PTCL):results from the BELIEF trial[J]. J Clin Oncol, 2013, 31(18S):8507.
29. O'Brien SM, axton Df CM. PhaseⅠ study of obatoclax mesylate (GXl5-070) a small mo1ecule pan-bcl-2 family antagonist in patients with advanced chronic lymphocytic leukemia[J]. Blood, 2009, 113(2):299-305.
30. 朱军, 丁宁. 从机制阐述淋巴瘤治疗药进展[N]. 医师报, 2013-01-05(5).
31. Bruns I, Fox F, Reinecke P, et al. Complete remission in a patient with relapsed angioimmunoblastic T-cell lymphoma following treatment with bevacizumab[J]. Leukemia, 2005, 19(11):1993-1995.
32. Foss FM, Zinzani PL, Vose JM, et al. Peripheral T-cell lymphoma[J]. Blood, 2011, 117(25):6756-6767.

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外周T细胞淋巴瘤的治疗进展

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