Single-agent thalidomide induces response in T-cell lymphoma

What's New in Cutaneous T-Cell Lymphoma-Associated Pruritus

Cutaneous T-cell lymphomas are a heterogenous group of lymphomas that cause various skin manifestations. Severe pruritus occurs frequently in cutaneous T-cell lymphoma and negatively impacts patients' quality of life. The pathophysiology of cutaneous T-cell lymphoma-associated itch is complex and involves various immune cells, inflammatory cytokines, and neuroimmune interactions. Treating cutaneous T-cell lymphoma pruritus can be challenging, and there have been few randomized controlled studies evaluating the use of antipruritic treatments in these patients. Systemic therapies targeting the disease have also been shown to have some antipruritic effects. Furthermore, although biologic therapy has revolutionized the treatment of other pruritic skin conditions, the use of biologics in cutaneous T-cell lymphoma remains controversial.

Thalidomide plus chemotherapy exhibit enhanced efficacy in the clinical treatment of T-cell non-Hodgkin's lymphoma: A prospective study of 46 cases

The treatment of T-cell non-Hodgkin's lymphoma (T-NHL) remains challenging. There is currently no standard regimen for the treatment of T-NHL in the first- or second-line setting. Thalidomide was previously shown to exert antitumor effects through inhibiting angiogenesis, promoting apoptosis and immunomodulatory activity. However, all the previous studies on the treatment of lymphoma with thalidomide included patient samples of limited size. In the present study, 46 cases of eligible T-NHL patients were randomized into i) the control group (conventional combined chemotherapy, n=22) and ii) the thalidomide group (thalidomide plus combined chemotherapy, n=24). The median dose of thalidomide was 200 mg (range, 150-400 mg) every night, without reported severe side effects. The clinical response to treatment was as follows: Complete response (CR) in 12 cases, partial response (PR) in 7, stable disease (SD) in 1 and progressive disease (PD) in 4 cases in the thalidomide group; and CR in 8 cases, PR in 6, SD in 3 and PD in 5 cases in the control group. The CR rate was 50.0 and 36.4% in the thalidomide and the control groups, respectively (P<0.05). The median progression-free and overall survival were 12 and undefined months, respectively, in the thalidomide group and 6 and 17 months, respectively, in the control group. The toxicity profile was considered acceptable in both groups. Our results indicated that thalidomide plus combined chemotherapy may exhibit enhanced efficacy in the clinical treatment of T-NHL. In addition, this type of treatment may reduce the frequency of adverse gastrointestinal reactions and help alleviate fear of chemotherapy. Therefore, thalidomide plus combined chemotherapy may be a viable option for the clinical treatment of T-NHL.

Solitary pulmonary plasmacytoma: report of two cases

We report two cases of solitary plasmacytoma of the lung. Computed tomographic scan disclosed in case A a solid tissue formation in a cystic pulmonary lesion and in case B a solitary nodule. Suggesting aspergilloma in A and pulmonary malignancy in B diagnostic thoracotomies were performed and the respective findings were resected. In both cases a diagnosis of plasmacytoma was made. Postoperatively multiple myeloma was ruled out. Solitary pulmonary plasmacytoma is a very rare condition and to the best of our knowledge plasmacytoma within a cystic lung lesion has not been described so far. After curative resection treatment the prognosis of these circumscript lesions should be excellent.

Targeted therapies for non-Hodgkin lymphoma: rationally designed combinations

Non-Hodgkin lymphoma is a diverse group of lymphoid malignancies treated historically with cytotoxic chemotherapy. Recent technologic advances have enabled the development of new therapies specifically targeted to inhibit various pathways involved in disease pathophysiology. Led by the anti-CD20 monoclonal antibody rituximab, these agents are expected to revolutionize patient care. Several new drugs might have limited single-agent activity but could combine with other targeted therapies to produce significant effects. Although the current level of understanding makes this sort of rational combination challenging, there is evidence that certain combinations might be very effective. Examples include the combination of rituximab with other monoclonal antibodies, immunomodulatory drugs, Bcl-2 inhibitors, and bortezomib. All of these agents face the challenge of optimal integration with rituximab. The strategies most likely to produce initial success will be those that incorporate rituximab in sensitive patients, as well as those that target patient populations with rituximab-refractory disease. Ideally, these studies will incorporate biologic correlates, such that the mechanisms of action and the patients most likely to benefit can be better defined. We discuss several combinations, their rationale, and the clinical evidence that justifies further evaluation.