Treatment Of Small And Mediumsized Pleomorphic Tcell Lymphoma And Cd30 Large Tcell Lymphoma

Patients with CD30~ LTCL or small/medium-sized PTCL usually present with solitary, localized, or generalized plaques, nodules, or tumors without spontaneous regression.96 Both entities do not express CD30 with absence of a Th2 cytokine profile in CD30~ LTCL.97 In CD30- LTCL, large cells comprise over 30% of the dermal infiltrate and might resemble classical MF undergoing large cell transformation. Multiagent systemic chemotherapy is recommended in most cases, with radiotherapy limited to localized disease, although abbreviated responses are often seen with a high relapse rate. This was supported by Bekkenk et al., who reported on 82 patients with CD30~ peripheral T-cell lymphoma.96 Forty-six patients were diagnosed with a primary cutaneous CD30~ LTCL. Most patients with solitary or localized skin lesions were treated with radiation, whereas patients presenting with multifocal skin lesions or with extracutaneous involvement were treated with doxorubicin-based chemotherapy. A complete remission was achieved in 12 (63%) of 19 patients treated with radiotherapy and in 5 (27%) of 18 patients treated with doxorubicin-based chemotherapy. Complete remissions were generally short lived, with a median duration of 6 months for radiotherapy-treated patients and 10 months for patients treated with doxorubicin-based chemotherapy. Twelve of 19 patients (63%) with small/medium-sized PTCL reached a complete remission, including 10 (83%) of 12 treated with radiotherapy and 2 (40%) of 5 patients treated with doxorubicin-based chemotherapy. The median response duration for the complete responders was 58 months. Patients with small- or medium-sized PTCL had a significantly better prognosis, with a 5-year overall survival rate of 45% compared to 12% in patients with primary cutaneous CD30~ LTCL.

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  • Mairi Hughes
    How is pleomophic lymphoma treated?
    7 years ago

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