title: Impressive activity of lenalidomide monotherapy in refractory angioimmunoblastic T-cell lymphoma: report of a case with long-term follow-up.
abstract: Angioimmunoblastic T-cell lymphoma (AITL) is characterized by an aggressive clinical course and unfavourable prognosis. Refractory AITL patients have very few treatment options. Lenalidomide has previously been reported to have clinical efficacy in this setting; however, long-term reports are limited. A 59-year-old man was referred to the hospital with fatigue, skin rash, weight loss and generalized lymphadenopathy and was diagnosed with AITL; clinical stage was IV B with bone marrow involvement. The patient had an unsatisfactory response despite three lines of conventional chemotherapy and radiotherapy. The patient received lenalidomide monotherapy (25 mg once daily) on days 1 to 21 of every 28-day cycle for six cycles, followed by maintenance therapy with six cycles of lenalidomide 15 mg once daily on days 1 to 21 of every 28-day cycle. A computed tomography scan was assessed before lenalidomide treatment, after the third cycle, at disease restaging 2 months after completion of the induction phase, every 3 months during the maintenance phase and every 6 months during the follow-up period. At the last evaluation, after a follow-up of 30 months, the patient maintained a clinical and radiological complete response. The treatment was well tolerated with manageable toxicity. Lenalidomide treatment demonstrated for the first time in the literature impressive and long-term clinical efficacy in a heavily pretreated chemorefractory AITL patient.
authors.affiliation: Unit of Hematology, "S. Maria alle Scotte" University Hospital, Siena, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Fabbri
authors.forename: Emanuele
authors.initials: E
authors.lastname: Cencini
authors.forename: Alice
authors.initials: A
authors.lastname: Pietrini
authors.forename: Alessandro
authors.initials: A
authors.lastname: Gozzetti
authors.forename: Marzia
authors.initials: M
authors.lastname: Defina
authors.forename: Giulia
authors.initials: G
authors.lastname: Fontanelli
authors.forename: Maria Antonietta
authors.initials: MA
authors.lastname: Mazzei
authors.forename: Luca
authors.initials: L
authors.lastname: Volterrani
authors.forename: Monica
authors.initials: M
authors.lastname: Bocchia
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D003131:Combined Modality Therapy; D003561:Cytarabine / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D003907:Dexamethasone / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage / Q000031:analogs & derivatives; D019008:Drug Resistance, Neoplasm; D015507:Drugs, Investigational / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D007155:Immunologic Factors / Q000627:therapeutic use*; D000077269:Lenalidomide; D016411:Lymphoma, T-Cell, Peripheral / Q000188:drug therapy* / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D011092:Polyethylene Glycols / Q000008:administration & dosage; D011241:Prednisone / Q000008:administration & dosage; D012074:Remission Induction; D016879:Salvage Therapy; D013792:Thalidomide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077235:Vinorelbine; D000093542:Gemcitabine
chemical_list: D020533:Angiogenesis Inhibitors; D015507:Drugs, Investigational; D007155:Immunologic Factors; D009944:Organoplatinum Compounds; C506643:liposomal doxorubicin; D003561:Cytarabine; D003841:Deoxycytidine; D011092:Polyethylene Glycols; D013792:Thalidomide; D014747:Vinblastine; D003907:Dexamethasone; D004317:Doxorubicin; D000077269:Lenalidomide; D000077235:Vinorelbine; D007069:Ifosfamide; D011241:Prednisone; D000093542:Gemcitabine