Prolonged survival of patients with angioimmunoblastic T‐cell lymphoma after high‐dose chemotherapy and autologous stem cell transplantation. The GELTAMO experience

Rodríguez, José A.; Conde, Eulogio; Gutiérrez, Antonio; Arranz, Reyes; Gandarillas, M.; León, Ángel; Ojanguren, Jesús; Sureda, Anna; Carrera, Dolores; Bendandi, Mauricio; Moraleda, José M.; Ribera, Josep‐Marǐa; Albó, Carmen; Morales, Alfonso; Garcı́a, Juan Carlos; Fernández, Pascual; Cañigral, Guillermo; Bergua, Juan; Caballero, Marı́a Dolores

doi:10.1111/j.1600-0609.2007.00815.x

Cited by 54 publications

(29 citation statements)

References 30 publications

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“…It can be noted that we could not find the IPI associated with the prognosis in this setting. Several retrospective works focusing on particular subsets of PTCL, such as AIL, have also found a place for ASCT, both in the salvage and in the frontline setting, 23,24 with similar results to the bigger PTCL-NOS group.…”

Section: Retrospective Studies Of Asct For Ptclmentioning

confidence: 65%

Hematopoietic SCT for peripheral T-cell lymphoma

Gutiérrez

Caballero

Perez-Manga

et al. 2008

Bone Marrow Transplant

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Results of conventional chemotherapy for high-risk peripheral T-cell lymphoma (PTCL) are poor compared with those for their aggressive B-cell counterparts. We aim to review the current data on the use of hematopoietic SCT in these patients in both frontline and salvage settings. With respect to autologous SCT (ASCT), conclusions from retrospective studies are that ASCT in the salvage setting is as useful in PTCL as in aggressive B-cell lymphomas and also that consolidation in first complete response of high-risk patients has very good results when compared with conventional chemotherapy (with long-term PFS higher than 50%). From first frontline prospective clinical trials, it appears that ASCT is feasible and has a low TRM (o5%); consolidation in first complete response is associated with a very good outcome; around 25% of patients do not undergo ASCT due mainly to disease progression; new approaches aimed at increasing the number of chemosensitive patients should be found. Furthermore, 25-30% of patients deemed complete responders post transplant still relapse afterward. For all these mainly chemoresistant patients, there is preliminary evidence that allogeneic SCT (Allo-SCT) may produce a plateau in survival curves (with long-term PFS around 50%), which indicates a graft-versus-PTCL effect. For this reason, Allo-SCT procedures are the object of ongoing clinical trials.

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Section: Retrospective Studies Of Asct For Ptclmentioning

confidence: 65%

Hematopoietic SCT for peripheral T-cell lymphoma

Gutiérrez

Caballero

Perez-Manga

et al. 2008

Bone Marrow Transplant

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“…Similarly favorable results are those in Rodríguez's retrospective analysis of AIL patients with a 3-year OS of 60 % (ref. 30 ).…”

Section: Discussionmentioning

confidence: 99%

Prolonged Survival of Patients With Peripheral T-Cell Lymphoma After First-Line Intensive Sequential Chemotherapy With Autologous Stem Cell Transplantation

Procházka¹,

Faber²,

Raida³

et al. 2009

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Background: Nodal peripheral T-cell lymphomas (PTCLs) are infrequent subtypes of non-Hodgkin's lymphomas. The WHO classification recognizes three subgroups of nodal PTCL: peripheral T-cell lymphoma not otherwise specified (PTCL, NOS), anaplastic large cell lymphoma (ALCL) and angioimmunoblastic lymphoma (AIL). The clinical course is aggressive and despite multiagent chemotherapy, the median survival is about 2 years. Optimal first-line chemotherapy is not established and the role of high-dose therapy with autologous stem cell support is still controversial.Aim: To analyze the long-term outcome of PTCL patients treated with intensive first-line chemotherapy with highdose therapy and autologous transplant consolidation.Method: Sequential chemotherapy protocol consisting of 3 cycles of CHOEP-21-like regimen (PACEBO), 1 cycle of an ifosfamide and methotrexate-based regimen (IVAM) and a priming regimen with high-dose cytosine arabinoside (HAM). Consolidation was provided with myeloablative conditioning (BEAM 200) and autologous stem cell support. Eighty-four patients with aggressive high-risk lymphoma were treated with the sequential protocol from 2000 to 2007 in our institution. Here we report our experience with 18 patients with nodal PTCL (10 PTCL, NOS; 3 ALCL, ALKnegative; 2 ALCL, ALK-positive; 2 ALCL, unknown ALK status; 1 AIL).Results: Eleven (61 %) patients achieved complete remission, 3 (17 %) partial remission and 4 (22 %) patients failed the procedure. The overall response rate was 77.8 %. After a median follow-up of 25.7 months, nine patients relapsed or progressed (6 PTCL, NOS; 2 ALCL ALK-positive; 1 ALCL ALK-negative; median 14.1 months) and four patients died (lymphoma progression). The relapse was treated with allogeneic stem transplantation in one patient. The 2-year progression-free survival (PFS) was 52 % (95 % CI, 0.27 to 0.76); the 2-year overall survival rate reached 71 % (95 % CI, 0.47 to 0.95).Conclusion: Our results show that intensive first-line chemotherapy with high-dose therapy and autologous transplant consolidation offers a chance for long-term survival in patients with chemosensitive PTCL.

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“…Similarly favorable results are those in Rodríguez's retrospective analysis of AIL patients with a 3-year OS of 60% (ref. 39 ). According to our experience, a significant number of patients with nodal PTCL may benefit from the intensive first line therapy and early consolidation with autologous stem cell transplantation.…”

Section: Subanalysis Of Pet/ct Assessmentmentioning

confidence: 99%

Long-Term Outcome of Patients With Peripheral T-Cell Lymphoma Treated With First-Line Intensive Chemotherapy Followed by Autologous Stem Cell Transplantation

Procházka¹,

Faber²,

Raida³

et al. 2011

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Background. Peripheral T-cell lymphomas (PTCL) are infrequent subtypes of non-Hodgkin's lymphomas. The clinical course is aggressive and the median survival is about 2-3 years. An optimal first-line chemotherapy protocol has not been established and the role of high-dose therapy with autologous stem cell transplantation (ASCT) is still unclear.Aim. To analyze the long-term outcome of unselected PTCL patients treated with intensive first-line chemotherapy with high-dose therapy and ASCT.Method. Here we report our experience with 29 patients with PTCL. The histological subtypes were as follows: peripheral T-cell lymphoma, not otherwise specified n=13; anaplastic large cell lymphoma (ALCL) ALK-negative n=5; ALCL ALK-positive n=3; ALCL with an unknown ALK status n=3; angioimmunoblastic lymphoma n=1; hepatosplenic lymphoma n=1; Sézary syndrome n=1; and enteropathy-associated T-cell lymphoma n=2. The median age at diagnosis was 48 years (29-64), most patients had advanced Ann Arbor stages (22 patients, 77%), IPI score ≥3 was found in 13 (45%) and PIT score ≥2 in 17 (59%) of the 29 patients. Eighteen patients received first-line high-dose therapy and autologous SCT consolidation; two patients were consolidated with allogeneic SCT in the 1st complete remission and one patient in the 1st relapse. Ten patients with FDG-avid lymphoma were examined with integrated Positron emission tomography/ Computed tomography (PET/CT) at the time of diagnosis and after first-line therapy, two other patients were assessed with Positron emission tomography/ Computed tomography (PET/CT) only at time of restaging.Results. Nineteen (66%) patients achieved complete remission, 3 (10%) partial remission and 7 (24%) patients failed the treatment. The overall response rate was 76%. PET negativity (complete metabolic response) after therapy was achieved in 8/12 (75%) individuals. After a median follow-up of 55.1 months, 14 (48.3%) patients relapsed or progressed and nine patients died (lymphoma progression). Eleven patients (50% of chemosensitive patients) survived more than 50 months. Three of the long-term survivors were treated with allogeneic SCT. The 2-year event-free survival (EFS) was 52% (95% confidence interval [CI], 0.33-0.71); the 2-year overall survival (OS) rate reached 65% (95%CI, 0.47-0.84). PET negativity was associated with a lower probability of relapse (chi-square p=0.09).Conclusion. Our data show that intensive first-line therapy with etoposide-doxorubicine-based regimens and ASCT consolidation may lead to long-term disease control in about a half of patients with chemosensitive PTCL. Achievement PET negativity is probably an essential prerequisite for long-term complete remission.

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Prolonged survival of patients with angioimmunoblastic T‐cell lymphoma after high‐dose chemotherapy and autologous stem cell transplantation. The GELTAMO experience

Cited by 54 publications

References 30 publications

Hematopoietic SCT for peripheral T-cell lymphoma

Hematopoietic SCT for peripheral T-cell lymphoma

Prolonged Survival of Patients With Peripheral T-Cell Lymphoma After First-Line Intensive Sequential Chemotherapy With Autologous Stem Cell Transplantation

Long-Term Outcome of Patients With Peripheral T-Cell Lymphoma Treated With First-Line Intensive Chemotherapy Followed by Autologous Stem Cell Transplantation

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