ArticleEJHaem2026
Modified Newcastle Regimen Improves Survival Despite Central Nervous System Relapse in Monomorphic Epitheliotropic Intestinal T-Cell Lymphoma.
Article in EJHaem, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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16 authors.
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Abstract
Background: Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) is a rare, aggressive malignancy with a median overall survival (OS) of 7-15 months. The Newcastle regimen, comprising cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), ifosfamide, etoposide, and epirubicin (IVE), and intermediate-dose methotrexate for central nervous system (CNS) prophylaxis, has demonstrated promising outcomes in enteropathy-associated T-cell lymphoma (EATL) but has not been evaluated in MEITL, where the CNS relapse risk informing methotrexate use remains poorly characterized. Methods: In this real-world cohort of 56 patients with MEITL diagnosed from 2002 to 2025, outcomes were compared between those who received the modified Newcastle (mNewcastle) regimen omitting methotrexate (CHOP/IVE) and those treated with CHOP-based chemotherapy. Survival was estimated using the Kaplan-Meier method with multivariable Cox regression, and CNS relapse was analyzed using a competing risks framework. Results: Of 52 patients receiving systemic chemotherapy, 22 received the mNewcastle regimen and 28 received CHOP-based chemotherapy, with comparable baseline characteristics. With a median follow-up of 50 months, the mNewcastle was associated with significantly longer median progression-free survival (PFS; 14.4 vs. 6.6 months, Conclusion: The mNewcastle regimen may provide superior survival compared with CHOP-based chemotherapy in MEITL, while CNS relapse remains a clinical concern.
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