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Disappointing outcome of autologous stem cell transplantation for enteropathy-associated T-cell lymphoma.

AbstractBACKGROUND:
Despite treatment, enteropathy-associated T-cell lymphoma has a very poor outcome. Chemotherapy can be complicated by small bowel perforation, gastrointestinal bleeding and development of enterocolic fistulae. Here we report on the feasibility, safety and efficacy of high-dose chemotherapy followed by autologous stem cell transplantation in patients with enteropathy-associated T-cell lymphoma (three upfront and one at relapse), with or without prior partial small bowel resection.
METHODS:
Four patients [two males, two females, mean age 65 years (range 60-69 years)] received high-dose chemotherapy followed by autologous stem cell transplantation. Partial small bowel resection has been performed in three patients.
RESULTS:
All four patients completed the mobilization and leucopheresis procedures successfully and subsequently received conditioning chemotherapy and transplantation. Engraftment occurred in all patients. No major non-haematological toxicity or transplantation-related mortality was observed. One patient has ongoing complete remission 32 months after transplantation. Three patients died from relapse within few months after autologous stem cell transplantation.
CONCLUSIONS:
Autologous stem cell transplantation seems unsatisfactory for patients with enteropathy-associated T-cell lymphoma. More intensive conditioning and aggressive chemotherapy with/or without targeted immunotherapy as well as allogenous stem cell transplantation needs to be explored.
AuthorsA Al-Toma, W H M Verbeek, O J Visser, K C Kuijpers, J J Oudejans, H C Kluin-Nelemans, C J J Mulder, P C Huijgens
JournalDigestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver (Dig Liver Dis) Vol. 39 Issue 7 Pg. 634-41 (Jul 2007) ISSN: 1590-8658 [Print] Netherlands
PMID17531561 (Publication Type: Case Reports, Journal Article)
Topics
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols (administration & dosage)
  • Celiac Disease (complications, therapy)
  • Feasibility Studies
  • Female
  • Humans
  • Ileum (pathology)
  • Lymphoma, T-Cell (complications, etiology, therapy)
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Peripheral Blood Stem Cell Transplantation
  • Remission Induction
  • Transplantation Conditioning
  • Transplantation, Autologous
  • Treatment Outcome

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