A trial of fludarabine and cyclophosphamide followed by thalidomide for angioimmunoblastic lymphoma

Cancer type:

Blood cancers
High grade lymphoma
Lymphoma
Non-Hodgkin lymphoma

Status:

Results

Phase:

Phase 2

This trial was for people just diagnosed with a rare type of non Hodgkin lymphoma called angioimmunoblastic lymphoma. 

Cancer Research UK supported this trial.

More about this trial

Angioimmunoblastic lymphoma is a type of high grade Open a glossary item lymphoma that affects blood cells called T cells. You may hear your doctors call it angioimmunoblastic T-cell lymphoma or AITL.

CHOP chemotherapy is the usual treatment for angioimmunoblastic lymphoma. But compared to other types of lymphoma the outlook (prognosis Open a glossary item) is poor and AITL sometimes comes back after treatment. So researchers are trying to find ways to improve treatment.

In this trial they looked at a combination of 2 chemotherapy drugs called fludarabine and cyclophosphamide. This drug combination has been used to treat other types of lymphoma. But doctors didn’t know how well it would work for angioimmunoblastic lymphoma.  

They also looked at a type of biological therapy Open a glossary item called thalidomide. They wanted to find if having thalidomide after chemotherapy helped keep the lymphoma under control.

The aims of the trial were to:

  • see if fludarabine and cyclophosphamide helped people with angioimmunoblastic lymphoma
  • find if having thalidomide after chemotherapy also helped
  • learn more about the side effects

Summary of results

The trial team found that fludarabine and cyclophosphamide followed by thalidomide shouldn’t be used as a first line treatment Open a glossary item for angioimmunoblastic lymphoma. 

This was a phase 2 trial

Everyone had fludarabine and cyclophosphamide followed by thalidomide. 

15 people joined the trial. The team were able to look at the results of 13 people.  

When the researchers looked at how well the fludarabine and cyclophosphamide worked they found that for:

  • 6 people there was no sign of their lymphoma (complete response Open a glossary item)
  • 3 people their lymphoma had shrunk (partial response Open a glossary item)
  • 4 people their lymphoma got worse 

7 people went on to have thalidomide after chemotherapy. 

  • 4 people’s lymphoma got worse 
  • 3 people’s lymphoma didn’t get any better or any worse  

The average length of time people lived without their lymphoma coming back was 5 ½ months.

The average length of time people lived after treatment was just under 15 months. 

The worst side effects of fludarabine and cyclophosphamide included:

  • a drop in blood cells
  • infection
  • diarrhoea
  • tiredness (physically and mentally)

The worst side effects of thalidomide included:

  • a drop in blood cells
  • lung infection (pneumonia) 

The trial team concluded that fludarabine and cyclophosphamide followed by thalidomide didn’t work well for people with angioimmumoblastic lymphoma. 

There is no standard treatment Open a glossary item for this type of lymphoma. Further research is needed to improve the outcome for people with AITL and to decide the most effective treatments. 

We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item) and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Dr Claudius Rudin

Supported by

Cancer Research UK
Experimental Cancer Medicine Centre (ECMC)
NIHR Clinical Research Network: Cancer

Other information

This is Cancer Research UK trial number CRUK/06/023.

If you have questions about the trial please contact our cancer information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:

540

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Last reviewed:

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