Monoclonal Antibody Therapy of T-Cell Leukemia and Lymphoma

Abstract

T-cell leukemias and lymphomas are a heterogeneous group of uncommon tumors that account for 7-15% of lymphomas. [1] They represent approximately 6,500 new cases annually in the United States. Typically patients with malignant T-cell disorders present with highgrade lesions, advanced stage disease and have systemic or “B” symptoms at diagnosis. Until relatively recently these diseases were treated with the same anthracycline-based chemother‐ apy regimens used to treat B-cell lymphomas. With few exceptions, the outcomes are poorer with lower response rates, shorter times to progression, and shorter median survivals com‐ pared to B-cell lymphomas. A number of new agents have recently entered the clinic for the treatment of T-cell lymphomas. [2] These include the histone deacetylase inhibitors voronistat (Zolinza®) and romidepsin (Istodax®) approved for treatment of previously treated cutaneous T-cell lymphoma (CTCL), the antifolate, pralatrexate (Fotolyn®) indicated for the treatment of relapsed or resistant peripheral T-cell lymphoma (PTCL), and the immunotoxin brentuximab vedotin (Adcetris®) for the treatment of relapsed anaplastic large cell lymphoma (ALCL). These newer agents join a handful of drugs approved for the treatment of T-cell lymphomas including beraxotene (Targretin®) and the interleukin-2-diphtheria toxin fusion protein, denileukin diftitox (Ontak®).