LAUSR

Currently, the CHOP regimen (cyclophosphamide, vincristine, adriamycin, and prednisolone) is most commonly administered initial treatment for newly diagnosed peripheral T‐cell lymphoma (PTCL). However, PTCLs respond poorly to this regimen and thus have a poor prognosis. The prognosis of PTCL is known to differ depending on the histological type. Anaplastic large cell lymphoma (ALCL), anaplastic lymphoma kinase (ALK)‐positive has been reported to be highly susceptible to CHOP therapy. ALCL, ALK‐negative is a CHOP‐ resistant lymphoma, and no definite salvage therapy has yet been established for these cases or relapsed disease after CHOP therapy. According to a previous report, a combination therapy regimen including L‐asparaginase yielded better prognostic outcomes for relapsed/refractory PTCL cases, compared with treatment without L‐asparaginase. Brentuximab vedotin (BV) monotherapy has been reported to prolong the survival prognosis of patients with relapsed/refractory ALCL. However, this therapy has also been associated with a higher recurrence rate. Another cohort study of patients with NK/T cell lymphoma reported the efficacy and safety of LOP therapy (L‐asparaginase, vincristine, and dexamethasone). Furthermore, BV has been suggested as an effective alternative to bleomycin in ABVD therapy (adriamycin, bleomycin, vinblastine, and dacarbazine) and vincristine in CHOP therapy. Based on the above reports, we herein report a novel combination therapy regimen in which BV was substituted for vincristine in LOP therapy (BV, L‐asparaginase, and dexamethasone). The patient was a 68‐year‐old Japanese man with a 1‐week history of a fever and sore throat before hospitalization. Computed tomography (CT) scan confirmed the left tonsillar mass and revealed bilateral cervical lymphadenopathies. Subsequently, a left tonsil resection biopsy was performed, and the histopathological analysis led to a diagnosis of ALCL, ALK‐negative, Ann Arbor clinical stage IIB, International Prognostic Index high‐risk (Figure 1A‐E). Eastern Cooperative Oncology Group Performance Status Scale (ECOG PS) was 2 at the time of hospitalization. CHOP therapy was initiated after diagnosis, and CT scan revealed that the patient achieved a partial response (PR) at the end of 4 cycles. However, newly enlarged lymph nodes