Chemo-free salvage treatment outperforms traditional chemotherapy in advanced lines of relapsed/refractory subcutaneous panniculitis-like T-cell lymphoma

Chao Chen; Jingjing Yin; Minghui Duan; Wei Wang; Danqing Zhao; Chong Wei; Congwei Jia; Wei Zhang; Daobin Zhou; Yan Zhang

doi:10.3389/fimmu.2024.1476875

Chemo-free salvage treatment outperforms traditional chemotherapy in advanced lines of relapsed/refractory subcutaneous panniculitis-like T-cell lymphoma

Front Immunol. 2024 Dec 9:15:1476875. doi: 10.3389/fimmu.2024.1476875. eCollection 2024.

Authors

Chao Chen^#¹, Jingjing Yin^#², Minghui Duan¹, Wei Wang¹, Danqing Zhao¹, Chong Wei¹, Congwei Jia³, Wei Zhang¹, Daobin Zhou¹, Yan Zhang¹

Affiliations

¹ Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
² Department of Hematology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
³ Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

^# Contributed equally.

Abstract

Introduction: Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare subtype of non-Hodgkin lymphoma with a good prognosis, but the optimal treatment for relapsed/refractory (R/R) SPTCL has been rarely discussed.

Methods: This study aims to compare the efficacy of conventional chemotherapy and chemo-free immunomodulatory regimen for R/R SPTCL. We retrospectively reviewed the patients with first relapse or primary refractory SPTCL between September 1997 and October 2020.

Results: A total of 19 patients with R/R SPTCL with a median age of 34 were included. All patient received the first-line chemotherapy-based treatment with a median PFS of 1.8 months. In these patients, 16 received salvage second-line treatment with an ORR of 31.3% and a median TTNT of 3.0 months. 13 of these 16 patients received chemotherapy-based treatment, resulting in a median TTNT of 2.4 months. 2 of these 16 patients received allogeneic hematopoietic stem cell transplantation and achieved long term complete remission (CR). In third-line treatment, 7 patients received chemotherapy-based regimen and 6 received chemo-free regimen such as VRMP (bortezomib, lenadomide and methylprednisolone) regimen and CsA plus IFNα regimen. The median TTNT of chemotherapy and chemo-free group were 3.2 months and not reached, respectively.

Discussion: Chemo-free group had a better TTNT than chemotherapy group (p=0.007). The use of chemotherapy-free regimens for R/R SPTCL appears promising and warrants further validation.

Keywords: T-cell lymphoma; chemo-free regimen; chemotherapy; immunotherapy; subcutaneous panniculitis-like T-cell lymphoma.

MeSH terms

Adult
Aged
Antineoplastic Combined Chemotherapy Protocols* / therapeutic use
Female
Hematopoietic Stem Cell Transplantation
Humans
Lymphoma, T-Cell* / drug therapy
Lymphoma, T-Cell* / therapy
Male
Middle Aged
Neoplasm Recurrence, Local / drug therapy
Panniculitis* / diagnosis
Panniculitis* / drug therapy
Retrospective Studies
Salvage Therapy* / methods
Treatment Outcome
Young Adult

Supplementary concepts

Subcutaneous panniculitis-like T-cell lymphoma

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was funded by the National High Level Hospital Clinical Research Funding (2022-PUMCH-B-029) and Capital’s Funds for Health Improvement and Research (2024-2-4011).