High-dose chemotherapy and autologous stem cell transplantation in peripheral T-cell lymphoma: the GEL-TAMO experience.

Abstract

BACKGROUND:

T-cell immunophenotype constitutes an unfavorable prognostic factor in aggressive non-Hodgkin's lymphomas. High-dose chemotherapy with autologous stem-cell rescue (HDC/ASCT) is the best salvage therapy for patients with aggressive B-cell lymphomas. However, results with this therapy in peripheral T-cell lymphoma (PTCL) are not well defined.

PATIENTS AND METHODS:

From January 1990 to December 1999, 115 patients with PTCL underwent HDC/ASCT inside the Grupo Español de Linfomas/Trasplante Autólogo de Médula Osea (GEL-TAMO) registry. At diagnosis the median age was 41 years and 60% of patients presented with two or three risk factors from the adjusted International Prognostic Index (a-IPI). Thirty-two per cent of patients were transplanted in first complete response (CR), 62% in chemosensitive disease and 5% in refractory disease.

RESULTS:

Eighty-six per cent of the patients attained a CR and 5% a partial response (PR). With a median follow-up of 37 months (range 1-133), overall survival (OS), time-to-treatment failure (TTF) and disease-free survival (DFS) at 5 years was 56%, 51% and 60%, respectively; for the 37 patients transplanted in first CR, OS and DFS at 5 years were 80% and 79%, respectively. Lactase dehydrogenase (LDH), a-IPI and disease status pre-transplant were associated with outcome.

CONCLUSIONS:

More than half of patients with chemosensitive disease who were transplanted are expected to be alive at 5 years. We confirm the utility of the pre-transplant IPI system in predicting outcome. Salvage treatment results with HDC/ASCT in PTCL are similar to those found in corresponding aggressive B-cell lymphomas.

• Authors: J Rodríguez, M D Caballero, A Gutiérrez, J Marín, J J Lahuerta, A Sureda, E Carreras, A León, R Arranz, A Fernández de Sevilla, J Zuazu, J García-Laraña, J Rifon, R Varela, M Gandarillas, J SanMiguel, E Conde
• Journal: Annals of oncology : official journal of the European Society for Medical Oncology (Ann Oncol) Vol. 14 Issue 12 Pg. 1768-75 (Dec 2003) ISSN: 0923-7534 [Print] England
• PMID: 14630683 (Publication Type: Clinical Trial, Journal Article, Multicenter Study)

Chemical References

• Cytarabine
• Etoposide
• Melphalan
• Carmustine

Topics

• Adolescent
• Adult
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, therapeutic use)
• Carmustine (administration & dosage)
• Cytarabine (administration & dosage)
• Disease-Free Survival
• Etoposide (administration & dosage)
• Female
• Humans
• Lymphoma, T-Cell, Peripheral (drug therapy)
• Male
• Melphalan (administration & dosage)
• Middle Aged
• Neoplasm Staging
• Peripheral Blood Stem Cell Transplantation
• Prognosis
• Retrospective Studies
• Risk Factors
• Salvage Therapy
• Transplantation, Autologous
• Treatment Outcome
• Whole-Body Irradiation