Which two drugs are used to treat small T cell lymphoma in the intestine?

• A. Prednisolone and chlorambucil
• B. Prednisone and azathioprine
• C. Doxorubicin and lomustine
• D. Metronidazole and sucralfate

Answer: (A)

Indolent, small T-cell lymphoma in the intestine is best managed with a combination that is effective yet tolerable for long-term control. Prednisolone provides rapid anti-lymphoid activity and helps reduce inflammation, while chlorambucil, an oral alkylating agent, targets the neoplastic lymphocytes with relatively mild toxicity. This pairing is specifically chosen because it offers good control of the disease with fewer side effects, leading to longer survival compared with more aggressive chemotherapy regimens.

In contrast, drugs like doxorubicin and lomustine are more intensive, higher-toxicity chemotherapies typically reserved for higher-grade or more aggressive lymphomas. Prednisone with azathioprine is not a standard anti-lymphoma combination and azathioprine can worsen outcomes by suppressing the immune response in a way that doesn’t effectively target the cancer. Metronidazole and sucralfate address GI symptoms and mucosal protection, not cancer control, so they don’t treat the lymphoma itself.