Patients with hepatosplenic T cell lymphoma (HSTCL) who have received intensive multiagent induction chemotherapy and achieved disease control face a critical next decision: consolidation. This protocol addresses that specific post-induction step.
The initial line for HSTCL involves intensive induction regimens — including platinum-containing combinations such as ICE (ifosfamide, carboplatin, and etoposide), cytarabine-containing regimens such as IVAC (ifosfamide, etoposide, and cytarabine), anthracycline-based regimens including CHOP or CHOP-like schedules, and antimetabolite-based therapies such as pentostatin or pralatrexate.
When disease control is achieved after induction, the evidence-based next step involves a hematopoietic stem cell transplantation (HSCT)-based consolidative strategy. Allogeneic transplantation is reported more often and is the generally preferred approach — the full protocol specifies the relevant conditioning and transplantation considerations.
DOI: 10.1182/bloodadvances.2025015857
If disease control is achieved, strong consideration should be given to proceeding with consolidative HSCT.
Allogeneic HSCT has been reported more often in children and adolescents with HSTCL than autologous HSCT.
However, data suggest that myeloablative regimens that include total-body irradiation may yield superior outcomes compared with reduced-intensity conditioning regimens.
Autologous HSCT has been reported much less frequently as a treatment strategy for children and adolescents with HSTCL.
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