The aggressive peripheral T-cell lymphomas: 2017.

Area of Science:

• Hematology
• Oncology
• Lymphoma Research

Background:

• T-cell lymphomas (PTCL) constitute 10%-15% of lymphoid malignancies.
• Geographic variations exist, with higher PTCL incidence in Asia.

Purpose of the Study:

• To review the diagnosis, staging, and risk-adapted therapy of aggressive peripheral T-cell lymphomas.
• To highlight challenges in PTCL diagnosis and the importance of subtype-specific treatment.

Main Methods:

• Diagnosis relies on the World Health Organization classification, with variable inter-observer reproducibility.
• Staging utilizes the Ann Arbor Classification; PET scans may aid staging.
• Risk stratification considers PTCL subtypes, with anaplastic large-cell lymphoma (ALK-positive) showing better prognosis.

Main Results:

• Anaplastic large-cell lymphoma responds well to CHOP-like regimens.
• Autotransplantation in remission improves outcomes for younger patients with angioimmunoblastic T-cell lymphoma.
• Localized nasal natural killer/T-cell lymphoma shows high cure rates with radiotherapy.
• Enteropathy-associated and hepatosplenic PTCL have poor prognoses, though some benefit from intensive therapy.

Conclusions:

• Accurate PTCL diagnosis and subtype identification are crucial for effective treatment.
• Novel therapeutic approaches are needed for PTCL-not otherwise specified and other refractory subtypes.
• Risk-adapted therapy, including radiotherapy and chemotherapy, improves outcomes for specific PTCL subtypes.