title: Use of retinoic acids in the treatment of peripheral T-cell lymphoma: a pilot study.
abstract: OBJECTIVE
  We have systemically analyzed, both in vitro and in vivo, the effect of 13-cis-retinoic acids (RA) on non-Hodgkin's lymphoma (NHL).
  
  
  METHODS
  The in vitro growth-inhibitory effect of 13-cis-RA was examined in 11 (T cell, five; B cell, six) lymphoma cell lines by a tetrazolium colorimetric assay. A pilot clinical trial with oral 13-cis-RA 1 mg/kg/d was conducted in a selected group of 18 lymphoma patients, of whom 16 had failed to respond to at least one regimen of intensive chemotherapy. The in vitro and in vivo effects of 13-cis-RA were correlated with immunophenotypes, RA-induced changes of morphology, and patterns of DNA fragmentation of the lymphoma cells.
  
  
  RESULTS
  Four of five T-lymphoma cell lines and none of six B-lymphoma cell lines were sensitive (concentration of 50% growth inhibition [IC50] < 1.5 microns) to 13-cis-RA (P = .015). In the clinical trial, five (two Ki-1, one angioinvasive type, one diffuse mixed cell, and one diffuse large cell) complete remissions and one (Ki1) partial remission were observed in 12 patients with peripheral T-cell lymphoma (PTCL), while none of six patients with B-cell lymphoma responded to 13-cis-RA. 13-cis-RA-induced cellular differentiation and apoptosis, as evidenced by the more mature morphology, characteristic nuclear condensation, and DNA ladder pattern signifying internucleosomal fragmentation, were demonstrated in the sensitive cell lines, as well as in the remitting lymphoma tissues.
  
  
  CONCLUSIONS
  The 13-cis-RA appears to be active on lymphomas of T-lineage and their therapeutic indication may be extended to include some subtypes of PTCL. The mechanisms of action are related to differentiation and apoptosis of lymphoma cells. There appears to be no cross-resistance between 13-cis-RA and conventional chemotherapy.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Republic of China.
authors.forename: A L
authors.initials: AL
authors.lastname: Cheng
authors.forename: I J
authors.initials: IJ
authors.lastname: Su
authors.forename: C C
authors.initials: CC
authors.lastname: Chen
authors.forename: H F
authors.initials: HF
authors.lastname: Tien
authors.forename: J D
authors.initials: JD
authors.lastname: Lay
authors.forename: B R
authors.initials: BR
authors.lastname: Chen
authors.forename: Y S
authors.initials: YS
authors.lastname: Pu
authors.forename: R L
authors.initials: RL
authors.lastname: Hong
authors.forename: M C
authors.initials: MC
authors.lastname: Shen
authors.forename: C H
authors.initials: CH
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D004354:Drug Screening Assays, Antitumor; D005260:Female; D006801:Humans; D015474:Isotretinoin / Q000627:therapeutic use*; D016411:Lymphoma, T-Cell, Peripheral / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D014407:Tumor Cells, Cultured / Q000187:drug effects / Q000473:pathology
chemical_list: D015474:Isotretinoin