title: Cyclosporine, prednisone, and high-dose immunoglobulin treatment of angioimmunoblastic T-cell lymphoma refractory to prior CHOP or CHOP-like regimen.
abstract: Angioimmunoblastic T-cell lymphoma (AITL) is a rare, distinct subtype of peripheral T-cell lymphoma, possessing an aggressive course and poor prognosis with no standard therapy. Twelve patients who have failed at least two initial CHOP or CHOP-like regimens were enrolled in this study and treated with individualized cyclosporine (CsA), prednisone (PDN), and monthly, high-dose intravenous immunoglobulin (HDIVIG). The dose of CsA was adjusted individually based on the blood trough concentration of CsA and renal function. All patients were examined for response, toxicity and survival. The most significant toxicities (≥ grade 2) were infection (16.7%), renal insufficiency (8.3%), hypertension (8.3%), diabetes (8.3%) and insomnia (16.7%). Discontinuation of treatment occurred in one patient (8.3%) due to grade 3 renal toxicity and subsequent grade 4 pulmonary infection. Treatment-related death was not observed. The overall response rate was 75.0% (complete response, 33.3%; partial response, 41.7%). With a median follow-up of 25.5 months, the median duration of response was 20 months (range, 12 to 49 months) and the median progression-free survival (PFS) was 25.5 months (range, 10 to 56 months). The 2-year PFS rate was 81.5%. Our findings indicate the combination of CsA, PDN and HDIVIG is an effective salvage regimen for refractory or relapsed AITL with predictable and manageable toxicity.
authors.affiliation: Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China.
authors.forename: Xing-Gui
authors.initials: XG
authors.lastname: Chen
authors.forename: He
authors.initials: H
authors.lastname: Huang
authors.forename: Ying
authors.initials: Y
authors.lastname: Tian
authors.forename: Cheng-Cheng
authors.initials: CC
authors.lastname: Guo
authors.forename: Chao-Yong
authors.initials: CY
authors.lastname: Liang
authors.forename: Yao-Ling
authors.initials: YL
authors.lastname: Gong
authors.forename: Ben-Yan
authors.initials: BY
authors.lastname: Zou
authors.forename: Rui-Qing
authors.initials: RQ
authors.lastname: Cai
authors.forename: Tong-Yu
authors.initials: TY
authors.lastname: Lin
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000627:therapeutic use; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007136:Immunoglobulins / Q000008:administration & dosage / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D016411:Lymphoma, T-Cell, Peripheral / Q000188:drug therapy* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011239:Prednisolone / Q000627:therapeutic use; D012074:Remission Induction; D016879:Salvage Therapy; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D007136:Immunoglobulins; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011239:Prednisolone