When angioimmunoblastic T-cell lymphoma (AITL) has relapsed or is refractory to initial treatment and enrollment in a clinical trial is not possible, a structured salvage approach is needed. The protocol below addresses regimen selection, patient fitness assessment, and consolidation decisions for this setting.

Clinical Scenario

Relapsed or refractory AITL in patients for whom a clinical trial is not available. Subsequent management depends on patient fitness and response to salvage therapy, with transplant eligibility as a key decision point.

Treatment Approach

The protocol recommends platinum-based salvage chemotherapy that avoids cross-resistance with prior anthracycline-based treatment. For patients who are not fit enough for intensive chemotherapy, less intensive agents are addressed separately. Transplant-eligible patients who achieve a response may be candidates for consolidative stem cell transplantation — the full sequencing, specific regimen options, and transplant criteria are detailed in the complete protocol.

References

DOI: 10.1016/j.annonc.2025.01.023

If a clinical trial is not available, platinum-based regimens that are non-cross resistant to the first-line anthracycline-based ChT can be considered [III, B].
Options for r/r PTCL-NOS and TFHL include ICE, DHAP, GDP, IVAC-MTX and 5-aza (for TFHL only) [III, B].
Options for patients who are not fit enough for intensive ChT include lenalidomide (not EMA or FDA approved), bendamustine and cyclosporin A [III, B].
For HSCT-eligible patients responding to salvage therapy, HSCT (preferably allo-HSCT if not used in first line) can be considered [II, B].

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Treatment of Relapsed or Refractory Angioimmunoblastic T-cell Lymphoma

Clinical Scenario

Treatment Approach

References