Stuver Robert, Moskowitz Alison J
Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
Cancers (Basel). 2023 Jan 18;15(3):589. doi: 10.3390/cancers15030589.
Historic outcomes for patients with relapsed or refractory nodal-based T-cell lymphomas are poor, with survival generally measured in months in multiple reports from the late 20th and early 21st century. Until recently, salvage strategies have mostly been borrowed from other aggressive lymphomas. However, dedicated investigations into the pathogenesis of T-cell lymphomas have resulted in an outpouring of therapies that target these diseases in biologically rational strategies. In particular, an evolving appreciation of the multiple complex oncogenic pathways and epigenetic changes that underlie these diseases has led to numerous agents targeting these aberrancies. Moreover, large reports of salvage allogeneic stem cell transplants in T-cell lymphoma have now been published, showing that adaptive immunotherapy is a potentially curative strategy for patients with relapsed or refractory disease. This review highlights therapeutic advances for relapsed or refractory T-cell lymphomas, including cellular therapy and allogeneic stem cell transplant, and provides a framework for management.
复发或难治性淋巴结型T细胞淋巴瘤患者的历史预后较差,在20世纪末和21世纪初的多份报告中,生存期通常以月计算。直到最近,挽救策略大多借鉴自其他侵袭性淋巴瘤。然而,对T细胞淋巴瘤发病机制的专门研究催生了大量以生物学合理策略靶向这些疾病的治疗方法。特别是,对这些疾病所基于的多种复杂致癌途径和表观遗传变化的认识不断深入,催生了众多针对这些异常情况的药物。此外,现在已经发表了关于T细胞淋巴瘤挽救性异基因干细胞移植的大型报告,表明适应性免疫疗法对于复发或难治性疾病患者是一种潜在的治愈策略。本综述重点介绍了复发或难治性T细胞淋巴瘤的治疗进展,包括细胞疗法和异基因干细胞移植,并提供了一个管理框架。