Angioimmunoblastoma T-cell lymphoma

  Angioimmunoblastoma T-cell lymphoma (AITL) accounts for approximately 15-20% of primary peripheral T-cell lymphomas and has a poor prognosis. AITL is often associated with EBV infection and usually presents as an advanced lesion with poor physical status, elevated B symptoms and LDH, and a median survival of less than 3 years with conventional therapy.  A clinical study of AITL from the Nordic Lymphoma Study Group used CHOEP14 in combination with autologous hematopoietic stem cell transplantation (ASCT) to treat AITL. 160 patients with AITL between 2002 and 2007 were first treated with CHOEP14 chemotherapy for 6 cycles and CHOP14 chemotherapy for patients older than 60 years of age. A total of 30 patients were finally enrolled, with a median age of 57 years, 27% with PS score ≥2, 80% with stage III-IV, and 20 of the 30 patients received BEAM or BEAC induction chemotherapy and ASCT. The results showed that the ORR after 6 cycles of chemotherapy was 87%, and the ORR of patients receiving ASCT-treated patients had an ORR of 80%, suggesting that some patients developed disease progression soon after induction chemotherapy or transplantation. With a median follow-up of 32 months, the 4-year progression-free survival and overall survival were 47% and 50%, respectively. This study suggests that despite the problem of early relapse, CHOEP14 combined with ASCT remains an effective and feasible treatment option for first-line treatment of AITL.