Initial treatment considerations for subtypes of aggressive PTCL
| Subtype . | Suggested initial therapy . |
|---|---|
| PTCL-NOS | Consider BV+CHP for CD30+ histology; CHOEP,5 CHOP, dose-adjusted (DA)-EPOCH6 |
| Nodal lymphomas of TFH cell origin (including AITL) | Consider BV+CHP for CD30+ cases; CHOEP, CHOP, DA-EPOCH |
| ALCL, ALK+ and ALK− | BV+CHP |
| ATLL: acute and lymphomatous | Dose-adjusted EPOCH, BV+CHP for CD30+ cases |
| Extranodal T-NK lymphoma, nasal type | Nasal stages I and II include radiation; stage IV, extranasal: combination chemotherapy (asparaginase-based) |
| Intestinal TCL, EATL, and MEITL | Consider the Newcastle regimen7 |
| Hepatosplenic TCL | Ifosfamide, carboplatin, etoposide (ICE) |
| Primary cutaneous CD8+ aggressive epidermotropic cytotoxic TCL | Consider combination chemotherapy |
| Breast implant–associated ALCL: extended disease beyond the capsule | BV±CHP, CHOEP, CHOP, (DA)-EPOCH |
| Subtype . | Suggested initial therapy . |
|---|---|
| PTCL-NOS | Consider BV+CHP for CD30+ histology; CHOEP,5 CHOP, dose-adjusted (DA)-EPOCH6 |
| Nodal lymphomas of TFH cell origin (including AITL) | Consider BV+CHP for CD30+ cases; CHOEP, CHOP, DA-EPOCH |
| ALCL, ALK+ and ALK− | BV+CHP |
| ATLL: acute and lymphomatous | Dose-adjusted EPOCH, BV+CHP for CD30+ cases |
| Extranodal T-NK lymphoma, nasal type | Nasal stages I and II include radiation; stage IV, extranasal: combination chemotherapy (asparaginase-based) |
| Intestinal TCL, EATL, and MEITL | Consider the Newcastle regimen7 |
| Hepatosplenic TCL | Ifosfamide, carboplatin, etoposide (ICE) |
| Primary cutaneous CD8+ aggressive epidermotropic cytotoxic TCL | Consider combination chemotherapy |
| Breast implant–associated ALCL: extended disease beyond the capsule | BV±CHP, CHOEP, CHOP, (DA)-EPOCH |
ATLL, adult T-cell leukemia/lymphoma; CHOEP, cyclophosphamide, hydroxydaunorubicin, vincristine (Oncovin), etoposide, prednisone; (DA) EPOCH, (dose-adjusted) etoposide, prednisone, vincristine (Oncovin), cyclophosphamide, hydroxydaunorubicin.