Spontaneous regression in mature T-cell non-Hodgkin lymphoma.

IF 2.3 4区医学 Q2 HEMATOLOGY Expert Review of Hematology Pub Date : 2025-01-01 Epub Date: 2024-12-07 DOI:10.1080/17474086.2024.2439469

Akihiro Ohmoto, Shigeo Fuji

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Abstract

Introduction: Spontaneous regression (SR) is observed in some patients with mature T-cell non-Hodgkin lymphoma (MTCL), including adult T-cell leukemia/lymphoma (ATL), although the incidence is rare.

Area covered: We extracted 31 cases with MTCL who experienced SR based on a literature search and summarized the patient characteristics and clinical outcomes.

Expert opinion: MTCL with SR included various subtypes, the most common being ATL (n = 17). Five of 24 cases (21%) maintained SR for more than 5 years, and the median duration of SR was 2 years. Sixteen of 31 cases (52%) experienced tumor relapse after SR. Two retrospective studies including ATL cases showed SR rates of 18% and 4%, respectively. Representative triggers are infection and surgical biopsies, and possible mechanisms include immunological mechanisms such as cross-reactivity of virus-specific T cells with tumor antigens. The diagnostic criteria for SR are not standardized among reports, and the clinical outcomes are not fully described. Practically, observation is the only accepted strategy after SR was achieved. In the era of molecular targeted therapy or immunotherapy, new strategies including maintenance therapy after SR could be discussed, although clinical data are lacking.

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成熟t细胞非霍奇金淋巴瘤的自发消退。

在一些成熟t细胞非霍奇金淋巴瘤（MTCL）患者中，包括成人t细胞白血病/淋巴瘤（ATL），可以观察到自发消退（SR），尽管发病率很少见。研究范围：我们在文献检索的基础上提取了31例MTCL经历SR的病例，并总结了患者的特征和临床结果。专家意见：伴有SR的MTCL包括多种亚型，最常见的是ATL （n = 17）。24例患者中有5例（21%）的SR维持超过5年，SR的中位持续时间为2年。31例患者中有16例（52%）术后肿瘤复发。包括ATL病例在内的两项回顾性研究显示，肿瘤复发率分别为18%和4%。典型的触发因素是感染和手术活检，可能的机制包括免疫机制，如病毒特异性T细胞与肿瘤抗原的交叉反应。报告中对SR的诊断标准没有标准化，临床结果也没有完全描述。实际上，观察是实现SR后唯一可接受的策略。在分子靶向治疗或免疫治疗时代，可以讨论包括SR后维持治疗在内的新策略，尽管缺乏临床数据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Hematology HEMATOLOGY-

CiteScore

4.70

自引率

3.60%

发文量

审稿时长

6-12 weeks

期刊介绍： Advanced molecular research techniques have transformed hematology in recent years. With improved understanding of hematologic diseases, we now have the opportunity to research and evaluate new biological therapies, new drugs and drug combinations, new treatment schedules and novel approaches including stem cell transplantation. We can also expect proteomics, molecular genetics and biomarker research to facilitate new diagnostic approaches and the identification of appropriate therapies. Further advances in our knowledge regarding the formation and function of blood cells and blood-forming tissues should ensue, and it will be a major challenge for hematologists to adopt these new paradigms and develop integrated strategies to define the best possible patient care. Expert Review of Hematology (1747-4086) puts these advances in context and explores how they will translate directly into clinical practice.