Esta página cubre el enfoque de tratamiento de primera línea basado en evidencia para el linfoma de células T asociado a enteropatía (EATL) en el momento del diagnóstico inicial. Se consideran múltiples estrategias de régimen, y la aptitud del paciente orienta la elección del enfoque.
La evidencia actual respalda la quimioterapia combinada de primera línea, con consolidación mediante trasplante autólogo de células madre considerado en pacientes aptos para tratamiento intensivo. Existen varias vías de régimen — la selección entre ellas, su secuenciación y los criterios de elegibilidad para la consolidación se detallan en el protocolo estructurado completo.
DOI: 10.1002/jha2.1049
Cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) with or without etoposide consolidated by autologous stem cell transplantation (ASCT) are recommended for fit PTCL patients.
Patients are generally treated with cyclophosphamide, doxorubicin, vincristine, and prednisone—either with or without etoposide (CHO(E)P).
The strategy where one course of CHOP is followed by the IVE/MTX-regimen (ifosfamide/etoposide/epirubicin alternated with intermediate-dose MTX [3 g/m²]) followed by high-dose therapy – mostly carmustine/etoposide/cytarabine/melphalan (BEAM) – and ASCT has shown promising results in a case series of both 6 and 26 patients, where the 5-year progression-free survival (PFS) and OS were 52% and 60% respectively in the latter study.
A French study investigating CHP-BV followed by consolidation with ASCT as a frontline treatment for patients with EATL (n = 14) showed an overall response rate of 79% and those who responded all underwent ASCT.
View source ↗