Araştırma Makalesi
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Relaps ve refrakter T-hücreli lenfoma hastalarında pralatrexate kullanımı: gerçek yaşam verileri

Yıl 2023, Cilt: 62 Sayı: 2, 266 - 271, 12.06.2023

Öz

Amaç: T-hücreli lenfomalar, non-Hodgkin lenfomaların kötü prognozlu bir alt tipidir ve tedavi
seçenekleri sınırlıdır. Bir antimetabolit ilaç olan pralatrexate, relaps ve refrakter T-hücreli lenfoma
tedavisinde onaylanmıştır.
Gereç ve Yöntem: Çalışmamızda pralatreksat alan relaps ve refrakter T-hücreli lenfoma hastaları
ilacın etkinlik ve güvenliliği açısından retrospektif olarak değerlendirilmiştir.
Bulgular: Toplam 13 hasta alındı. Tanı anındaki ortanca yaş 63 olarak bulundu. En yaygın histolojik
tipler, büyük hücre transformasyonu gösteren mikozis fungoides (%31) ve anjiyoimmünoblastik Thücreli lenfomaydı (%31). Pralatreksattan önceki medyan sistemik tedavi sayısı 2’ydi (1-6 aralığında).
En sık görülen yan etki mukozitti (%54). Genel yanıt oranı %38'di (%15 tam remisyon ve %23 kısmi
remisyon). Ortanca OS 32±6,5 ay ve PFS 6,78±1,6 aydı.
Sonuç: Çalışmamız, pralatreksatın etkinliği ve güvenliği hakkında gerçek dünya verileri sağlamıştır ve
sonuçlar mevcut literatürü desteklemektedir. Toksisitesi kabul edilebilir düzeydedir ve periferik Thücreli lenfomalar üzerinde önemli etkinliği vardır.

Kaynakça

  • Swerdlow SH, Campo E, Pileri SA, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood 2016;127:2375-90.
  • Moskowitz AJ, Lunning MA, Horwitz SM. How I treat the peripheral T-cell lymphomas. Blood 2014;123:2636- 44.
  • Abouyabis AN, Shenoy PJ, Sinha R, Flowers CR, Lechowicz MJ. A Systematic Review and Meta-Analysis of Front-line Anthracycline-Based Chemotherapy Regimens for Peripheral T-Cell Lymphoma. ISRN Hematol 2011;2011:623924.
  • Horwitz S, O'Connor OA, Pro B, et al. Brentuximab vedotin with chemotherapy for CD30-positive peripheral T-cell lymphoma (ECHELON-2): a global, double-blind, randomised, phase 3 trial. Lancet 2019;393:229-240.
  • Petrich AM, Rosen ST. Peripheral T-cell lymphoma: new therapeutic strategies. Oncology (Williston Park) 2013;27:878-84.
  • Toner LE, Vrhovac R, Smith EA, et al. The schedule-dependent effects of the novel antifolate pralatrexate and gemcitabine are superior to methotrexate and cytarabine in models of human non-Hodgkin's lymphoma. Clin Cancer Res 2006;12:924-32.
  • Wang ES, O'Connor O, She Y, Zelenetz AD, Sirotnak FM, Moore MA. Activity of a novel anti-folate (PDX, 10- propargyl 10-deazaaminopterin) against human lymphoma is superior to methotrexate and correlates with tumor RFC-1 gene expression. Leuk Lymphoma 2003;44:1027-35.
  • Marchi E, Paoluzzi L, Scotto L, et al. Pralatrexate is synergistic with the proteasome inhibitor bortezomib in in vitro and in vivo models of T-cell lymphoid malignancies. Clin Cancer Res 2010;16:3648-58.
  • O'Connor OA, Pro B, Pinter-Brown L, et al. Pralatrexate in patients with relapsed or refractory peripheral Tcell lymphoma: results from the pivotal PROPEL study. J Clin Oncol 2011;29:1182-9.
  • Malik SM, Liu K, Qiang X, et al. Folotyn (pralatrexate injection) for the treatment of patients with relapsed or refractory peripheral T-cell lymphoma: U.S. Food and Drug Administration drug approval summary. Clin Cancer Res 2010;16:4921-7.
  • Cheson BD, Horning SJ, Coiffier B, et al. Report of an international workshop to standardize response criteria for non-Hodgkin's lymphomas. NCI Sponsored International Working Group. J Clin Oncol 1999;17:1244.
  • Bhurani M, Admojo L, Van Der Weyden C, et al. Pralatrexate in relapsed/refractory T-cell lymphoma: a retrospective multicenter study. Leuk Lymphoma 2021;62:330-6.
  • Hong JY, Yoon DH, Yoon SE, et al. Pralatrexate in patients with recurrent or refractory peripheral T-cell lymphomas: a multicenter retrospective analysis. Sci Rep 2019;9(1):20302.

Pralatrexate in patients with relapsed and refractory T-cell lymphomas: real world data

Yıl 2023, Cilt: 62 Sayı: 2, 266 - 271, 12.06.2023

Öz

Aim: T-cell lymphomas are a subtype of Non-Hodgkin lymphoma with a poor prognosis and treatment
options are limited. Pralatrexate, an antimetabolite drug, has been approved for the treatment of
relapsed and refractory T-cell lymphoma.
Materials and Methods: Our study retrospectively evaluated relapsed and refractory T-cell lymphoma
patients who received pralatrexate in terms of efficacy and safety of the drug.
Results: A total of 13 patients were recruited. The median age at diagnosis was 63 years. The most
common histologic types were mycosis fungoides with large cell transformation (31%) and
angioimmunoblastic T-cell lymphoma (31%). The median number of prior systemic therapies before
pralatrexate was 2 (range 1-6). The most common side effect was mucositis (54%). The overall
response rate was 38% (15% complete remission and 23% partial remission). The median OS was
32±6.5 months and PFS was 6.78±1.6 months.
Conclusion: Our study provided real-world data on the efficacy and safety of pralatrexate and
supports current literature. This drug has acceptable toxicity and significant effectiveness on peripheral
T-cell lymphomas.

Kaynakça

  • Swerdlow SH, Campo E, Pileri SA, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood 2016;127:2375-90.
  • Moskowitz AJ, Lunning MA, Horwitz SM. How I treat the peripheral T-cell lymphomas. Blood 2014;123:2636- 44.
  • Abouyabis AN, Shenoy PJ, Sinha R, Flowers CR, Lechowicz MJ. A Systematic Review and Meta-Analysis of Front-line Anthracycline-Based Chemotherapy Regimens for Peripheral T-Cell Lymphoma. ISRN Hematol 2011;2011:623924.
  • Horwitz S, O'Connor OA, Pro B, et al. Brentuximab vedotin with chemotherapy for CD30-positive peripheral T-cell lymphoma (ECHELON-2): a global, double-blind, randomised, phase 3 trial. Lancet 2019;393:229-240.
  • Petrich AM, Rosen ST. Peripheral T-cell lymphoma: new therapeutic strategies. Oncology (Williston Park) 2013;27:878-84.
  • Toner LE, Vrhovac R, Smith EA, et al. The schedule-dependent effects of the novel antifolate pralatrexate and gemcitabine are superior to methotrexate and cytarabine in models of human non-Hodgkin's lymphoma. Clin Cancer Res 2006;12:924-32.
  • Wang ES, O'Connor O, She Y, Zelenetz AD, Sirotnak FM, Moore MA. Activity of a novel anti-folate (PDX, 10- propargyl 10-deazaaminopterin) against human lymphoma is superior to methotrexate and correlates with tumor RFC-1 gene expression. Leuk Lymphoma 2003;44:1027-35.
  • Marchi E, Paoluzzi L, Scotto L, et al. Pralatrexate is synergistic with the proteasome inhibitor bortezomib in in vitro and in vivo models of T-cell lymphoid malignancies. Clin Cancer Res 2010;16:3648-58.
  • O'Connor OA, Pro B, Pinter-Brown L, et al. Pralatrexate in patients with relapsed or refractory peripheral Tcell lymphoma: results from the pivotal PROPEL study. J Clin Oncol 2011;29:1182-9.
  • Malik SM, Liu K, Qiang X, et al. Folotyn (pralatrexate injection) for the treatment of patients with relapsed or refractory peripheral T-cell lymphoma: U.S. Food and Drug Administration drug approval summary. Clin Cancer Res 2010;16:4921-7.
  • Cheson BD, Horning SJ, Coiffier B, et al. Report of an international workshop to standardize response criteria for non-Hodgkin's lymphomas. NCI Sponsored International Working Group. J Clin Oncol 1999;17:1244.
  • Bhurani M, Admojo L, Van Der Weyden C, et al. Pralatrexate in relapsed/refractory T-cell lymphoma: a retrospective multicenter study. Leuk Lymphoma 2021;62:330-6.
  • Hong JY, Yoon DH, Yoon SE, et al. Pralatrexate in patients with recurrent or refractory peripheral T-cell lymphomas: a multicenter retrospective analysis. Sci Rep 2019;9(1):20302.
Toplam 13 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Hematoloji
Bölüm Araştırma Makaleleri
Yazarlar

Eren Arslan Davulcu

Fatma Keklik Karadağ

Ayşenur Arslan

Zühal Demirci

Derya Demir

Nur Soyer

Fahri Şahin

Güray Saydam

Yayımlanma Tarihi 12 Haziran 2023
Gönderilme Tarihi 25 Aralık 2022
Yayımlandığı Sayı Yıl 2023Cilt: 62 Sayı: 2

Kaynak Göster

Vancouver Davulcu EA, Keklik Karadağ F, Arslan A, Demirci Z, Demir D, Soyer N, Şahin F, Saydam G. Pralatrexate in patients with relapsed and refractory T-cell lymphomas: real world data. ETD. 2023;62(2):266-71.

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