Targeted therapies in T-cell malignancies

Abstract

The World Health Organization (WHO) has classified T-cell malignancies into mature T-cell and natural killer (NK)-cell neoplasms and precursor T-cell lymphoblastic lymphoma/leukemia. Mature T-cell lymphomas, alternatively known as peripheral T-cell lymphomas (PTCLs), are rare diseases with extremely heterogeneous clinicopathologic profiles. Treatment protocols for PTCL are mostly adapted from those used for B-cell lymphomas, but the prognosis is generally worse. More recently, monoclonal antibodies, including alemtuzumab (Campath-1H, anti-CD52) and denileukin diftitox (Ontak, anti-CD25), have been shown to be effective in the treatment of T-prolymphocytic leukemia (T-PLL) and cutaneous T-cell lymphoma. The unique association of human T-cell lymphotropic virus in adult T-cell lymphoma/leukemia has also led to the use of anti-viral agents in this disease with significant improvement in outcome. A number of novel monoclonal antibodies and histone deacetylase inhibitors are also being evaluated. The roles of these targeted therapies as first-line treatment or in combination with conventional chemotherapy and the roles of autologous and allogeneic hematopoietic stem cell transplantation in PTCL need further investigation. © 2006 Springer-Verlag.