Comparison of clinical outcome after autologous stem cell transplantation between patients with peripheral T-cell lymphomas and diffuse large B-cell lymphoma

Abstract

Although patients with T-cell phenotype lymphomas are generally accepted to have worse prognosis than B-cell phenotype lymphomas, the studies comparing outcomes after autologous stem cell transplantation (ASCT) between peripheral T-cell lymphomas (PTCLs) and with diffuse large B-cell lymphoma (DLBCL) are few. In this study, we compared outcomes after ASCT between 23 patients with PTCLs and 54 patients with DLBCL. Univariate analysis showed that the timing of ASCT, complete response (CR) at ASCT, favorable lactate dehydrogenase/performance/stage, low/low-intermediate (L-LI) International Prognostic Index (IPI) and L-LI age-adjusted IPI (aaIPI) at ASCT were significant predictors of both OS and EFS. Multivariate analysis showed that CR and L-LI aaIPI at ASCT were favorable for both OS (hazard ratio (HR), 0.34; 95% CI, 0.14-0.81; P ¼ 0.016 and HR, 0.27; 95% CI, 0.12-0.57; P ¼ 0.001) and EFS (HR, 0.38; 95% CI, 0.17-0.85; P ¼ 0.020 and HR, 0.36; 95% CI, 0.17-0.77; P ¼ 0.008). B-cell or T-cell phenotype, however, had no impact on OS (HR, 0.56; 95% CI, 0.27-1.18; P ¼ 0.126) or EFS (HR, 0.62; 95% CI,; P ¼ 0.206). In conclusion, when compared to patients with DLBCL, patients with PTCLs did not have inferior outcomes after ASCT. T-cell phenotype itself may not have an effect on outcomes of PTCL patients who underwent ASCT.

Impact of Autologous and Allogeneic Stem Cell Transplantation in Peripheral T-Cell Lymphomas

“…In the salvage setting, several subgroup analysis and comparisons show similar results compared to diffuse large-cell B-cell lymphoma. This finding could recently be confirmed by Sohn et al [61]. Therefore, taken together the existing data, HDT-autoSCT seems a reasonable approach in relapsing and refractory PTCL particularly in those with chemotherapy-sensitive disease.…”

Treatment Options for Patients with Relapsing and Refractory Peripheral T-Cell Lymphoma

“…In many studies, the quality of remission at transplantation correlates with the outcome after salvage autoSCT. Usually a better long-term survival was reported in patients transplanted in CR compared with patients with other disease status at the time of transplantation [23,27,[32][33][34][35][36]. However, some authors could not confirm this finding [24,25,31].…”

“…Overall, no significant difference in OS was seen between both phenotypes [25,27,34]. In summary, high-dose chemotherapy followed by autoSCT in rrPTCLs is feasible and safe with a low morbidity and mortality rate.…”

How to predict the outcome in mature T and NK cell lymphoma by currently used prognostic models?

“…Despite inferior response to conventional chemotherapy, patients with PTCL did not have inferior outcome after ASCT in two studies. 51, 52 In a salvage setting, the 3-year OS after ASCT was approximately 36–48%. 53, 54, 55, 56, 57 In comparison with second-line chemotherapy, ASCT improved OS and DFS.…”