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Neutrophil Isolation and Analysis to Determine their Role in Lymphoma Cell Sensitivity to Therapeutic Agents
Published on: March 25, 2016
New perspectives in the therapeutic approach of peripheral T-cell lymphoma
Christian Gisselbrecht1, David Sibon2
1Hôpital Saint Louis, Institut d'hématologie Paris Diderot University.
Purpose Of Review:
Peripheral T-cell lymphoma (PTCL) is a heterogeneous group of mature T-cell and natural killer (NK)-cell neoplasms in the WHO 2016 classification. Patient prognosis is poor when treated with CHOP, and there is an unmet need for new drugs. Several agents have been developed for PTCL, and their use is the subject of this review.
Recent Findings:
Phase 2 studies demonstrated the activity of new drugs in Relapsed/refractory PTCL. Only four compounds were approved by the food and drug administration: romidepsin and belinostat, which are epigenetic modifiers, the antifolate agent pralatrexate, the immuno-conjugate brentuximab vedotin. New combinations have been tested, but the results were disappointing. Given the latest progress in biology, targeted agents are evaluated in different subtypes of PTCL. Relapsed anaplastic large-cell lymphoma exhibits improved prognosis with the approved anti-CD30 drug conjugate brentuximab vedotin. Localized nasal NK/T is treated with radiotherapy and nonanthracycline chemotherapy with L-asparaginase. Recently, immune checkpoint inhibitors demonstrated activity in NK/T lymphoma and can be used in elderly patients.
Summary:
Treatment remains a challenge for PTCL, and several targeted drugs provide new approaches. Progress will be made incrementally in the different subtypes. One of the critical situations facing new drugs is the ability to run robust clinical trials in rare diseases.
Insights
New targeted drugs show promise for peripheral T-cell lymphoma (PTCL) subtypes, addressing poor prognosis with current treatments. Challenges remain in clinical trials for rare diseases.
Area of Science:
- Hematology
- Oncology
- Immunology
Background:
- Peripheral T-cell lymphoma (PTCL) encompasses diverse T-cell and NK-cell neoplasms with poor prognosis.
- Current treatments like CHOP are insufficient, highlighting an unmet need for novel therapies.
Purpose of the Study:
- To review the development and application of new therapeutic agents for PTCL.
- To discuss recent advancements and challenges in PTCL treatment.
Main Methods:
- Review of Phase 2 studies evaluating new drugs in relapsed/refractory PTCL.
- Analysis of approved therapies including epigenetic modifiers, antifolates, and antibody-drug conjugates.
- Examination of targeted agents and immunotherapies in specific PTCL subtypes.
Main Results:
- Four agents approved: romidepsin, belinostat, pralatrexate, and brentuximab vedotin.
- New combinations yielded disappointing results; targeted agents show promise in specific subtypes.
- Brentuximab vedotin improves prognosis in relapsed anaplastic large-cell lymphoma; immune checkpoint inhibitors benefit NK/T lymphoma.
Conclusions:
- Targeted drugs offer new therapeutic avenues for challenging PTCL cases.
- Incremental progress is expected across different PTCL subtypes.
- Conducting robust clinical trials for rare diseases remains a significant hurdle.
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