Autologous Stem-Cell Transplantation As First-Line Therapy in Peripheral T-Cell Lymphomas: Results of a Prospective Multicenter Study

Reimer, Peter; Rüdiger, Thomas; Geissinger, Eva; Weißinger, Florian; Nerl, Christoph; Schmitz, Norbert; Engert, Andreas; Einsele, Hermann; Müller‐Hermelink, Hans Konrad; Wilhelm, Martin

doi:10.1200/jco.2008.17.4870

Cited by 382 publications

(305 citation statements)

References 52 publications

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“…1 Autologous stem cell transplantation is frequently used in eligible patients but relapse is frequent, especially in the case of chemoresistance at transplantation. 2 Allogenic SCT (allo-SCT) is increasingly used as an alternative strategy, based on a potent graft-versus-lymphoma effect (GvL). However, data from retrospective [3][4][5][6][7][8][9][10][11] and prospective non-randomized studies 12 are insufficient to recommend allo-SCT as first-line treatment.…”

Section: Introductionmentioning

confidence: 99%

Effect of immune modulation in relapsed peripheral T-cell lymphomas after post-allogeneic stem cell transplantation: a study by the Société Française de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC)

Mamez

Lévy

Chevallier

et al. 2015

Bone Marrow Transplant

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Peripheral T-cell lymphoma carries a poor prognosis. To document a possible graft-versus-lymphoma effect in this setting, we evaluated the impact of immunomodulation in 63 patients with peripheral T-cell lymphoma who relapsed after allogeneic transplant in 27 SFGM-TC centers. Relapse occurred after a median of 2.8 months. Patients were then treated with nonimmunologic strategies (chemotherapy, radiotherapy) and/or immune modulation (donor lymphocyte infusions (DLI) and/or discontinuation of immunosuppressive therapy). Median overall survival (OS) after relapse was 6.1 months (DLI group: 23.6 months, non-DLI group: 3.6 months). Among the 14 patients who received DLI, 9 responded and 2 had stable disease. Among the remaining 49 patients, a complete response accompanied by extensive chronic GvHD was achieved in two patients after tapering of immunosuppressive drugs. Thirty patients received radio-chemotherapy, with an overall response rate of 50%. In multivariate analysis, chronic GvHD (odds ratio: 11.25 (2.68-48.21), P = 0.0009) and skin relapse (odds ratio: 4.15 (1.04-16.50), P = 0.043) were associated with a better response to treatment at relapse. In a time-dependent analysis, the only factor predictive of OS was the time from transplantation to relapse (hazards ratio: 0.33 (0.17-0.640), P = 0.0009). This large series provides encouraging evidence of a true GvL effect in this disease.

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Section: Introductionmentioning

confidence: 99%

Effect of immune modulation in relapsed peripheral T-cell lymphomas after post-allogeneic stem cell transplantation: a study by the Société Française de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC)

Mamez

Lévy

Chevallier

et al. 2015

Bone Marrow Transplant

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“…The 5-year overall survival (OS) for common subtypes of PTCL, such as PTCL not otherwise specified (NOS) and angioimmunoblastic T-cell lymphoma, is 32% compared with only 14% for adult T-cell leukemia lymphoma [2] , and there is no standard treatment regimen at present. High-dose therapy and autologous stemcell transplants are still controversial [3,4] . The regimen of cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) remains the most commonly used chemotherapeutic treatment for PTCL.…”

Section: Introductionmentioning

confidence: 99%

Pharmacodynamic and pharmacokinetic study of pegylated liposomal doxorubicin combination (CCOP) chemotherapy in patients with peripheral T-cell lymphomas

et al. 2011

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Aim: To investigate the pharmacodynamic and pharmacokinetic parameters of pegylated liposomal doxorubicin (PLD) combined with cyclophosphamide, vincristine, and prednisolone in patients with peripheral T-cell lymphomas (PTCL). Methods: Seven chemonaive patients and four patients with relapsed peripheral T-cell lymphomas were treated with a CCOP regimen consisting of an intravenous administration of cyclophosphamide (750 mg/m 2 ), vincristine (1.4 mg/m 2 ), and PLD (30 mg/m 2 ) on d 1, as well as an oral administration of prednisolone (60 mg/m 2 ) on d 1-5. This regimen was repeated every 3 weeks for six cycles, and the clinical response and toxicity of the regimen were monitored. In addition, the plasma concentration of PLD at different time points was determined before and after treatment. The pharmacokinetics (PKs) software was used to estimate the pharmacokinetic parameters of PLD. Results: The 11 PTCL patients received 35 treatment cycles. Three of them achieved complete response (CR), two partial response (PR), four stable disease (SD), and two progressive disease (PD). The overall response rate (ORR) was 45.5%, and the CR rate was 27.3%. In the 7 chemonaive patients, three achieved CR, two PR, one SD, and one PD. The ORR was 71.4%, and CR rate was 42.9%. The median follow-up time was 15 months, but 6 out of 11 patients were dead at the time of data analysis. The 1-year overall survival rate was 45.5%, and the median progression-free survival (PFS) rate was 6.5 [95% confidence interval (95% CI) 3.17-19.02] with a survival rate of 11.5 months (95% CI 6.65-16.36). The main toxicity was myelosuppression. Oral mucositis and hand-foot syndrome seldom occurred. The PLD plasma concentration from nine patients ranged from 1.7036 to 9.2207 mg·L -1 after administration of the CCOP regimen (0-168 h). The pharmacokinetic parameters AUC 0-∞ , CL, t 1/2 , and V d were 910.76 mg/L·h, 0.043 L·h -1 ·m -2 , 68.40 h, and 3.56 L/m 2 , respectively. Conclusion: The CCOP regimen was effective and well tolerated in patients with peripheral T-cell lymphomas. The results of the pharmacokinetic parameters showed that PLD had long retention time in blood circulation.

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“…The results published by Cairoli et al [21] also support the concept of upfront autoSCT. Reimer et al [24] described within a similar approach a 3 year overall survival rate of 48 %. The results after autoSCT seem to be better in patients with AITL.…”

Section: Discussionmentioning

confidence: 97%

Treatment of High-Risk T-NHL with Stem Cell Transplantation: A Single Center Experience

Busemann

Klein

Schmidt

et al. 2014

Indian J Hematol Blood Transfus

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Prognosis of peripheral and other advanced T cell lymphomas is poor. 20 patients with a median age of 46.4 (range 20.5-64.1) years were treated with autoSCT (n = 6) or alloSCT (n = 14) from 1996 to 2013. All patients were at high risk either due to the IPI-score or to the fact that SCT was part of a salvage therapy. Conditioning prior to alloSCT was myeloablative in seven cases (50 %). The patients were pretreated with 8.5 (median, range 2-38) cycles of chemotherapy. Ten patients are alive in CR after a median follow-up of 1.3 years (range 0.1-13.3). OS was 53 % after one and 40 % after 10 years. Best survival was reached after related alloSCT (80 % at 10 years) compared to other modalities. GvHD did not influence survival. AlloSCT from related donors can cure patients from T-cell lymphomas. Unrelated alloSCT or high-dose therapy and autoSCT are an option for patients without a familiar donor.

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Autologous Stem-Cell Transplantation As First-Line Therapy in Peripheral T-Cell Lymphomas: Results of a Prospective Multicenter Study

Abstract: The results of this prospective study suggest a substantial impact on outcome for upfront autoSCT in PTCL and should be further evaluated in randomized trials. Pretransplantation treatment needs to be improved to increase the transplantation rate.

Cited by 382 publications

References 52 publications

Effect of immune modulation in relapsed peripheral T-cell lymphomas after post-allogeneic stem cell transplantation: a study by the Société Française de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC)

Effect of immune modulation in relapsed peripheral T-cell lymphomas after post-allogeneic stem cell transplantation: a study by the Société Française de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC)

Pharmacodynamic and pharmacokinetic study of pegylated liposomal doxorubicin combination (CCOP) chemotherapy in patients with peripheral T-cell lymphomas

Treatment of High-Risk T-NHL with Stem Cell Transplantation: A Single Center Experience

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