Esta página aborda a abordagem de tratamento de primeira linha baseada em evidências para o Linfoma de células T associado à enteropatia (EATL) no diagnóstico inicial. Múltiplas estratégias de esquemas são consideradas, com a aptidão do paciente orientando a escolha da abordagem.
As evidências atuais apoiam a quimioterapia combinada de primeira linha, com consolidação por meio de transplante autólogo de células-tronco considerada em pacientes aptos para tratamento intensivo. Existem várias vias de esquemas — a seleção entre elas, seu sequenciamento e os critérios de elegibilidade para consolidação estão detalhados no protocolo estruturado 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.
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