Guidelines for the management of mature T-cell and NK-cell neoplasms (excluding cutaneous T-cell lymphoma)

Br J Haematol. 2011 May;153(4):451-85. doi: 10.1111/j.1365-2141.2011.08651.x. Epub 2011 Apr 11.

Abstract

The peripheral T-cell neoplasms are a biologically and clinically heterogeneous group of rare disorders that result from clonal proliferation of mature post-thymic lymphocytes. Natural killer (NK) cell neoplasms are included in this group. The World Health Organization classification of haemopoietic malignancies has divided this group of disorders into those with predominantly leukaemic (disseminated), nodal, extra-nodal or cutaneous presentation. They usually affect adults and are more commonly reported in males than in females. The median age at diagnosis is 61 years with a range of 17-90 years. Although some subtypes may follow a relatively benign protracted course most have an aggressive clinical behaviour and poor prognosis. Excluding anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALCL), which has a good outcome, 5-year survival for other nodal and extranodal T-cell lymphomas is about 30%. Most patients present with unfavourable international prognostic index scores (>3) and poor performance status. The rarity of these diseases and the lack of randomized trials mean that there is no consensus about optimal therapy for T- and NK-cell neoplasms and recommendations in this guideline are therefore based on small case series, phase II trials and expert opinion.

Publication types

  • Practice Guideline
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use
  • Evidence-Based Medicine / methods
  • Female
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Incidence
  • Killer Cells, Natural*
  • Leukemia, T-Cell / diagnosis
  • Leukemia, T-Cell / epidemiology
  • Leukemia, T-Cell / therapy*
  • Lymphoma, T-Cell / diagnosis
  • Lymphoma, T-Cell / epidemiology
  • Lymphoma, T-Cell / therapy*
  • Lymphoma, T-Cell, Peripheral / therapy
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Young Adult

Substances

  • Antineoplastic Agents