Modified ESHAP regimen for relapsed/refractory T cell lymphoma: a retrospective analysis

Area of Science:

• Hematology
• Oncology
• Clinical Pharmacology

Background:

• Peripheral T cell lymphomas (PTCL) represent about 10% of non-Hodgkin lymphomas, often presenting aggressive disease and poor prognosis.
• Unlike B cell lymphomas, established chemotherapy standards for relapsed/refractory PTCL remain limited.
• The standard ESHAP regimen has known renal toxicities, necessitating treatment modifications.

Purpose of the Study:

• To evaluate the efficacy and safety of a modified ESHAP (mESHAP) regimen in patients with relapsed/refractory PTCL.
• To assess treatment outcomes including remission rates, overall survival (OS), and progression-free survival (PFS).
• To identify patient subgroups who may benefit most from the mESHAP regimen.

Main Methods:

• A retrospective analysis of 22 patients with relapsed/refractory PTCL treated with mESHAP between 2001 and 2012.
• The mESHAP regimen involved replacing cisplatin with carboplatin to mitigate renal toxicity.
• Patient data on diagnosis, treatment response, survival, and adverse events were analyzed.

Main Results:

• A complete remission (CR) rate of 18% and a partial remission (PR) rate of 14% were observed.
• Median OS and PFS were 11.0 and 2.5 months, respectively.
• Leukopenia was the most common side effect; renal impairment was infrequent. Better OS and PFS were associated with AITL histology and absence of bone marrow invasion.

Conclusions:

• The mESHAP regimen demonstrated activity in relapsed/refractory PTCL, with a notable safety profile regarding renal toxicity.
• Patients with angioimmunoblastic T cell lymphoma (AITL) or without bone marrow invasion showed improved survival outcomes.
• mESHAP is a potential treatment option for specific PTCL patient groups, especially when renal toxicity is a concern.