Audience Response:
Aggressive Peripheral T-cell Lymphoma: Optimal Management
Discussant: Owen O’Connor, MD, PhD

A 47-year-old female presents to her internist with generalized lymphadenopathy, fever of two weeks duration (T0 max = 1010), night sweats, and widely scattered raised erythematous skin lesions involving extremities, trunk, and face.  

    EVALUATION:
  • CBC: WBC = 9,500 (75% PMNs), Hgb = 11.8 g/dl, Platelets = 200,000
  • LDH: 1.5 x upper limit of normal
  • CT Scans: Confirm generalized lymphadenopathy in all major lymph node-bearing areas. No hepatosplenomegaly.
  • Biopsy: Excisional biopsy of a cervical lymph node and a skin biopsy are consistent with ALK-negative anaplastic large-cell lymphoma
  • Marrow: Infiltrate of morphologically consistent cells which are strongly CD30 positive and anaplastic lymphoma kinase (ALK) negative
  • ECOG performance status: 1

Participate:

Part I: Which of the following options would you suggest as initial therapy?

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Part II: If this patient achieves a complete response (CR) to initial therapy would you consider consolidative therapy with autologous stem cell transplant?

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Part III: The patient achieves a transient partial response (PR) to CHOP chemotherapy. However, disease progression occurs shortly after completion of 6 cycles of chemotherapy and before stem cell harvest can be accomplished.

Which of these options would you recommend now?

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Peripheral T-Cell Lymphoma

CME Posttest

This activity is supported by Allos Therapeutics, Inc; Cephalon, Inc; Genentech BioOncology; and Millennium, the Takeda Oncology Company.