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Non-Hodgkin lymphoma

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Enteropathy-associated T-cell lymphoma

Enteropathy-associated T-cell lymphoma (EATL) is a very rare type of T-cell lymphoma. It usually occurs in the small intestine, most often the middle part (jejunum) or lower part closest to the large intestine (ileum). It may also be called enteropathy-type T-cell lymphoma or intestinal T-cell lymphoma.

EATL is associated with celiac disease (sprue). People with celiac disease cannot tolerate gluten, a protein found in many grains, such as wheat, rye and barley (gluten sensitivity). A gluten-free diet helps prevent EATL from developing, so this type of lymphoma does not commonly occur in people diagnosed with celiac disease at a young age. Most adults are diagnosed with celiac disease at the same time as their lymphoma or shortly before their lymphoma is diagnosed.

People with EATL often have ulcers in the small intestine, a blockage (obstruction) or a hole in the wall of the intestine (intestinal perforation). All of these can cause abdominal pain. EATL may spread to the liver, spleen, lymph nodes, gallbladder, stomach, colon or skin.

EATL is usually a fast-growing (aggressive) lymphoma. The prognosis for people with EATL is often not very good.

Treatment

Treatment for EATL is based on the extent and the location of the lymphoma in the small intestine. There is no standard approach to treating EATL.

Supportive therapy

People with EATL are usually malnourished and have lost weight because of long-standing diarrhea and difficulty digesting or absorbing nutrients from food (malabsorption). They often need nutritional support.

A gluten-free diet is also recommended.

Surgery

Surgery may be an option and is done to remove the damaged small intestine.

Chemotherapy

Chemotherapy may be offered to people who can tolerate it:

  • following surgery
  • when the cancer cannot be removed by surgery or is extensive

Combination chemotherapy is often used for this aggressive lymphoma. A variety of chemotherapy combinations may be used, including CHOP:

  • cyclophosphamide (Cytoxan, Procytox)
  • doxorubicin (Adriamycin)
  • vincristine (Oncovin)
  • prednisone (Deltasone)

For more detailed information on specific drugs, go to sources of drug information.

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