OBJECTIVES: Peripheral T-Cell Lymphoma (PTCL) is a rare subset of Non-Hodgkin’s Lymphoma (NHL), that carries poor prognostic outcomes. PTCL comprises approximately 5-10% of all new NHL cases in the UK. There are multiple subtypes of PTCL including PTCL- NOS, AITL, ALCL ALK+ve, ALCL ALK-ve, EATL, ATLL and HSTCL. Generally, combination chemotherapy is the standard frontline therapy, with clinical trials preferred where available. The purpose of this survey was to assess the current frontline management of PTCL in the UK.

METHODS: An electronic survey was completed by ten clinicians with experience of managing PTCL across the UK. Questions assessed the number and subtype of patients treated, guidelines used, standard treatment approach, expected efficacy of treatments and success rates of bridging to stem cell therapy (SCT).

RESULTS: An average of 19 patients are seen per centre per year (range: 10-32). The majority of patients treated have PTCL-NOS or AITL, with other subtypes seen less frequently. Standard frontline approach is CHOP-based therapy, with slight differences within the group, notably on whether or not to include etoposide, while two clinicians had a preference for IVE+ methotrexate. ALK+ve ALCL patients are generally treated with CHOP-based chemotherapy, and consolidative SCT is not considered, as their expected outcomes are better due to their good risk profile. The highest response rates (ORR and CR) to frontline therapy would be expected in patients with ALK+ve ALCL (86.1% and 76.9%), with the lowest in HSTCL (43.9% and 26.3%).

CONCLUSIONS: In the frontline setting for PTCL-NOS, AITL and sALCL ALK -ve, CHOP is the most frequently used regimen. However, this may be an inadequate option in higher risk groups, which may explain some variability in approach to treatment. Although there is inconclusive efficacy evidence, 20-30% of patients receive a consolidative transplant. There remains an unmet need in suitable treatment options for PTCL patients.