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Aggressive T‐cell lymphomas: 2021 Updates on diagnosis, risk stratification and management
Author(s) -
Zain Jasmine M.,
Haa Paul
Publication year - 2021
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.26270
Subject(s) - brentuximab vedotin , medicine , lymphoma , anaplastic large cell lymphoma , oncology , clinical trial , cd30 , antibody drug conjugate , peripheral t cell lymphoma , anaplastic lymphoma kinase , t cell , chimeric antigen receptor , targeted therapy , cancer research , immunotherapy , immunology , antibody , cancer , monoclonal antibody , immune system , malignant pleural effusion , lung cancer
Aggressive T‐cell lymphomas continue to have a poor prognosis. There are over 27 different subtypes of peripheral T‐cell lymphoma (PTCL), and we are now beginning to understand the differences between the various subtypes beyond histologic variations. Molecular Pathogenesis of Various Subtypes of PTCL Gene expression profiling (GEP) can help in diagnosis and prognostication of various subtypes including PTCL‐nos and anaplastic large cell lymphoma (ALCL). In addition, mutational analysis is now being incorporated in clinical trials of novel agents to evaluate various biomarkers of response to allow better therapeutic choices for patients. Targeted Therapies There are many targeted agents currently in various stages of clinical trials for PTCL that take advantage of the differential expression of specific proteins or receptors in PTCL tumors. This includes the CD30 directed antibody drug conjugate brentuximab vedotin. Other notable targets are CD25, CCR4, inhibition of PI3kinase – m TOR and JAK/STAT pathways. The ALK inhibitors are promising for ALK expressing tumors. Immunotherapies Allogeneic stem cell transplant continues to be the curative therapy for most aggressive subtypes of PTCL. The use of checkpoint inhibitors in the treatment of PTCL is still controversial. The most promising results have been seen in cases of extranodal natural killer cell/T‐cell (ENK/T) lymphomas and cutaneous T‐cell lymphomas (CTCL). Bispecific antibody based treatments as well as CAR‐T cell based therapies are in clinical trials.