ASH 2014 highlights: new therapeutic concepts for T cell lymphomas
The Annual Meeting of the American Society of Hematology (ASH) 2014 has highlighted a number of spectacular advances of the past couple of years for T cell lymphomas. These lymphomas are probably the most challenging of all types of hematologic malignancies: First, patients usually present in a very ill condition and in a very advanced stage of disease; second, they do not respond well to chemotherapy; and third, T cell lymphomas are rare diseases. They account for only 15 % of all cases of non-Hodgkin lymphomas and with more than 15 subtypes any subtype is very rare. Therefore, it requires joint forces of an international community to make advances in the understanding of the disease and to identify new treatment approaches. Another reason why the prognosis of T cell lymphomas has been dismal compared with its counterparts in B cell lymphomas is that historically we have applied the therapies from B cell lymphomas to T cell lymphomas. With the advances of large international preclinical studies, we now recognize that the paradigms we learned for B cell lymphomas are inappropriate for T cell lymphomas. An evolving basic science literature suggests that T cell lymphomas are highly enriched for various mutations involving epigenetic operations This might explain why T cell lymphomas are so uniquely poised to be sensitive to the class of epigenetic drugs such as histone deacetylase inhibitors.