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.
Anahtar Kelimeler
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.
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.
Anahtar Kelimeler
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.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Hematoloji |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 12 Haziran 2023 |
| Gönderilme Tarihi | 25 Aralık 2022 |
| Yayımlandığı Sayı | Yıl 2023Cilt: 62 Sayı: 2 |
