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Monoclonal Antibodies (mAb) in the Therapy of T-Cell Lymphomas

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T-Cell Lymphomas

Part of the book series: Contemporary Hematology ((CH))

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Abstract

T-cell lymphomas (TCLs) represent a heterogeneous group of lymphoid neoplasms. With the exception of ALK+ anaplastic large cell lymphoma (ALCL), early stage mycosis fungoides (MF) and T-large granular lymphocytic (LGL) leukemia, TCL respond poorly to conventional chemotherapy and have a poor prognosis. Malignant T-cells express a number of potential targets for immunotherapy, which are described in detail in this chapter. Monoclonal antibodies (mAbs) against a number of T-cell antigens have shown significant clinical activity in a variety of TCL and represent an important addition to the therapeutic toolbox, with durable remissions occurring in a subset of patients. The main toxicity of anti-T-cell mAbs is immune suppression, due to the fact that subsets of normal T-cells are also depleted during therapy. The degree and duration of T-cell lymphopenia and immune suppression produced by anti-T-cell mAbs is variable, but to date none has been shown to be completely free of these side effects. Since mAbs as single agents are not curative in TCL, they should be integrated in combination with other biological or chemotherapeutic agents, either simultaneously or sequentially. Maintenance therapy or retreatment based on the monitoring of minimal residual disease should also be considered although antigen mutation or modulation may limit repeated administration activity. Studies involving mAbs covalently bound to radioisotope or toxins to enhance their ability to destroy tumor cells show that immunoconjugates are more effective than “naked” mAbs. This multimodality strategy, together with a personalized, stage-specific approach represents the future in the management of TCL patients. Based on the spectrum of investigational mAbs now available and the activity shown, there is no doubt that mAbs therapy of TCL will continue to be an area of active interest expanding clinical trials. Long-term safety and recovery of cell-mediated immunity should be a key clinical endpoint in the ultimate risk-benefit assessment of these agents.

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Authors and Affiliations

  1. Department of Internal Medicine, The Ohio State University, 395 West 12th Avenue, 3rd floor, Columbus, OH, 43210, USA

    Lapo Alinari

  2. Department of Hematology, The Ohio State University, Columbus, OH, USA

    Pierluigi Porcu

  3. Department of Hematology, Hospices Civils de Lyon and Université Claude Bernard, Lyon, France

    Bertrand Coiffier

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  1. Lapo Alinari
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  2. Pierluigi Porcu
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  3. Bertrand Coiffier
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Correspondence to Lapo Alinari .

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  1. Yale University School of Medicine, Dept. of Medical Oncology/Hematology, Cedar Street 333, New Haven, 06520, Connecticut, USA

    Francine Foss

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Alinari, L., Porcu, P., Coiffier, B. (2013). Monoclonal Antibodies (mAb) in the Therapy of T-Cell Lymphomas. In: Foss, F. (eds) T-Cell Lymphomas. Contemporary Hematology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-170-7_14

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