Progress in the treatment of mature T-cell lymphoma

Abstract

Treatment outcomes of malignant lymphoma have improved due to the discovery of novel chemotherapeutic and molecular targeted agents as well as advances in their combination uses. However, the prognosis of T-cell lymphoma remains poorer than that of B-cell lymphomas, and progress is slow. The reasons include their chemotherapeutic resistant nature and the absence of effective antibody agents for T-cell lymphomas. The number of T-cell lymphoma subtypes increased from 21 in the WHO classification 2008 to 29 in the WHO classification 2016. This means that T-cell lymphomas are heterogeneous. T-cell lymphomas can be divided to ALK-positive anaplastic lymphoma (ALCL) with a good prognosis and others with poorer prognoses. ALK-positive ALCL can be successfully treated with CHOP, but the others cannot. P-glycoprotein resistant anthracyclines, etoposide, or hematopoietic stem cell transplantations are increasingly applied to improve outcomes, but no standard treatment approach has yet been established. Regarding relapsed/refractory T-cell lymphoma, many novel agents are currently under development. The treatment outcomes of T-cell lymphoma need to be improved by applying innovative strategies including further novel agents.