外周T细胞淋巴瘤讲稿修改（学习资料）课件.pptVIP

外周T细胞淋巴瘤治疗进展 外周T/NK细胞淋巴瘤定义 一组源于胸腺后成熟T淋巴细胞或自然杀伤(natural killer，NK)细胞的淋巴系统恶性肿瘤，其生物学行为及临床表现具有明显异质性。 外周T细胞淋巴瘤各亚型分布 外周T细胞淋巴瘤各亚型生物学异质性 PTCL不同亚型疾病异质性 CHOP治疗PTCL不同亚型生存资料 如何改善PTCL预后？ 传统治疗的探索 剂量强度与密集方案 高剂量化疗联合造血干细胞移植 新药的开发与应用 基于疾病异质性的特色治疗 开发应用于T细胞淋巴瘤的新药 开发应用于T细胞淋巴瘤的新药 吉西他滨治疗PTCL Phase Ⅱ Study of Bendamustine in Relapsed/Refractory T-Cell Lymphoma 普拉曲沙（Pralatrexate）治疗PTCL PROPEL Trial: Pralatrexate in Relapsed/Refractory PTCL Romidepsin治疗复发难治PTCLpivotal phase II study Romidepsin治疗复发难治PTCLpivotal phase II study Romidepsin治疗复发难治PTCLpivotal phase II study Conclusions:romidepsin should be further investigated in combination with chemotherapy in the frontline setting 单抗类药物治疗PTCL Phase Ⅲ CHOP+/-A in PTCL Phase II Study of Denileukin Diftitox + CHOP in PTCL: “CONCEPT” Trial DD18mg/kg/day on days 1 and 2，CHOP starting day 3，G-CSF day 4 Every 21 days, for 6-8 cycles N = 49 (ITT)，Median age, 52 years (range, 23-80 years) PTCL, NOS, n = 19；AITL, n = 10；ALCL, n = 8 第一代抗CD30单抗：毒性小，疗效有限 Phase Ⅱ Study: Brentuximab Vedotin (SGN-35) in Relapsed/Refractory ALCL Phase Ⅱ Study: Brentuximab Vedotin (SGN-35) in Relapsed/Refractory ALCL Anti-CCR4（ KW0761 ）治疗复发CCR4+ ATLL or PTCL Targets CCR4 (CC Chemokine receptor type 4) Expressed on sub-population of Treg cells (Th2 CD4+ T cells) 88% of patients with ATLL 38% of patients with PTCL Phase I/II Study 16 patients received antibody q week x 4 with escalating doses; 1 patient off study early secondary to treatment related side effects No MTD noted; recommended dose going forward 1 mg/kg RR 31%, 2CR 3PR Grade 3/4 toxicities included lymphopenia (10), neutropenia (3), leukopenia (2), zoster (1) Anti-CCR4（ KW0761 ）治疗复发CCR4+ ATLL，Phase 2 Trial Anti-CCR4（ KW0761 ）治疗复发CCR4+ ATLL，Phase 2 Trial Anti-CCR4（ KW0761 ）治疗复发CCR4+ ATLL，Phase 2 Trial CD30+ T-cell lymphomas: ALCL, PTCL-nos 初步研究显示，第一代抗CD30单克隆抗体治疗相关毒性小、临床耐受性良好。 SGN-35是第二代或改进型抗CD30单抗，其治疗复发耐药ALCL的Ⅱ期临床研究获得了高CR率和持续性的缓解期。 SGN-35与化疗联合的一线治疗值得期待。 CCR4+ T-cell lymphomas: ATLL，PTCL Angioimmunoblastic T-cell l