Different types of treatment are available, but the exact type of treatment is dependent on the subtype of<unk> . Chemotherapy Chemotherapy is widely used as the initial treatment to inhibit rapid growing abnormal cells in the body. Patients are usually treated with combination chemotherapy regimem known as CHOP, and it includes: * Cyclophosphamide: helps suppress the immune response and have a quick control of the disease * Hydroxydaunorubicin (Doxorubicin): blocks the enzyme that promotes growth and cell division * Oncovin (Vincristine): used to inhibit the growth of cancer cells by stopping one cancer cell from splitting into two cells * Prednisone: suppresses the immune system Chemotherapy involves the use of strong and powerful chemicals. This leads to certain side effects if it is not properly managed and may vary amongst individuals. Kidney and cardiac functions need to be monitored closely as there are concerns about toxification. High dosage of chemotherapy may damage the bone marrow, in which autologous stem cell therapy is a recommended follow-up treatment. Drugs Other common drugs used to treat<unk>  includes pralatrexate (fotolyn), Brentuximab vedotin (Adcetris) and Romidepsin (Istodax). Pralatrexate is the first approved drug to treat lymphoma by the Food and Drug Administration (FDA) in 2009. It is shown to reduce the size of lymphoma tumours. In cancer cells, the plasma membrane transporter reduced folate carrier type 1 (RFC-1) is overexpressed to produce enough folate for rapid proliferation. Folate is also known as vitamin B9, it is used to make DNA, RNA and metabolises amino acids that are required for cell divisions. Pralatrexate is an antifolate drug that enters and binds to RFC-1 as pralatrexate is structurally similar to normal metabolites in DNA synthesis. Pralatrexate occupies the binding sites of RFC-1, blocking critical enzymes from binding to RFC-1 and DNA synthesis cannot occur properly, resulting in cell death. Brentuximab vedotin is the first approved frontline treatment by FDA to treat<unk>  in 2018 and is mainly used to treat anaplastic large cell lymphoma. It has a chimeric monoclonal antibody (cAC10) that binds to the membrane protein CD30. This binding delivers monomethyl auristatin E (MMAE), an antimitotic agent that inhibits mitosis, and leads to anti-tumour activity. The vesicle containing drug is then fused with lysosome, which breaks the valine-citrulline linker between the main body of the drug and MMAE and releases MMAE into the tumour environment. The effectiveness of Brentuximab vedotin is high as 97% of patients had some tumour shrinkage while 87% of the patients had more than 50% of shrinkage in tumour size. Romidepsin is mainly used to treat cutaneous T-cell lymphoma. It has a disulphide bond and undergoes reduction reaction to thiol. Thiol binds to zinc and this complex binds to the binding site of histone deacetylase. As histone deacetylase is zinc-dependent, the activity of a cell is inhibited and leads to apoptosis. Autologous Stem Cell Treatment Physicians may recommend patients to undergo autologous stem cell treatment after initial chemotherapy as most patients with PTCL will relapse. It is also used when the lymphoma does not respond well to the initial treatment (refractory lymphoma). Patient's blood are drawn out from the body prior to chemotherapy treatment and stem cells are filtered out through a process called apheresis. Stem cells are infused back into the patient's bloodstream after chemotherapy treatment and replaces the damaged bone marrow or stem cells that are destroyed by the chemotherapy treatment. Patient's response to the treatment should be monitored closely as it takes 3-6 months for the immune system to recover. Extracorporeal Photopheresis (ECPP) Extracorporeal photopheresis is mainly used to treat cutaneous T-cell lymphoma. White blood cells are removed from the patient's blood and are treated using photoactive drugs called 8-methoxypsoralen (8-MOP) under ultraviolet light (UVA). White blood cells are then re-infused back into the patient's body after being treated.
Mature T-cell lymphoma
Aggressive lymphoma
Anaplastic large-cell lymphoma
Mixed-cell lymphoma
Pleomorphic T-cell lymphoma
Angioimmunoblastic T-cell lymphoma
Indolent lymphoma
Mantle cell lymphoma