Abstract | PURPOSE: PATIENTS AND METHODS: We report a retrospective, multicenter study of 146 patients with AITL who received ASCT. The source of the stem cells was peripheral blood in 143 patients. The conditioning regimen varied, and 74% of the patients received carmustine and 1,3-bis(2-chloroethyl)-1-nitrosourea; etoposide; ara-C; and melphalan chemotherapy. RESULTS: After a median follow-up of 31 months (range, 3 to 174 months), 95 patients (65%) remained alive, and 51 patients (35%) died. Forty-two patients died as a result of disease progression, and nine died as a result of regimen-related toxicity. The cumulative incidence of nonrelapse mortality was 5% and 7% at 12 and 24 months, respectively. The actuarial overall survival (OS) was 67% at 24 months and 59% at 48 months. The cumulative incidence of relapse was estimated at 40% and 51% at 24 and 48 months, respectively. Disease status at transplantation was the major factor that impacted outcome. Patients who received a transplant during first complete remission (CR) had significantly superior progression-free survival and OS. The estimated PFS rates for patients who received their transplants in CR were 70% and 56% at 24 and 48 months, respectively; 42% and 30% for patients with chemotherapy-sensitive disease at those time points, respectively; and 23% at both time points for patients with chemotherapy-refractory disease. CONCLUSION: This study shows that HDT and ASCT offers the possibility of long-term disease-free survival to patients with AITL. Early transplantation is necessary to achieve optimal results.
|
Authors | Charalampia Kyriakou, Carmen Canals, Anthony Goldstone, Dolores Caballero, Bernd Metzner, Guido Kobbe, Hans-Jochem Kolb, Joachim Kienast, Peter Reimer, Jurgen Finke, Gunnar Oberg, Ann Hunter, Niklas Theorin, Anna Sureda, Norbert Schmitz, Outcome-Lymphoma Working Party of the European Group for Blood and Marrow Transplantation |
Journal | Journal of clinical oncology : official journal of the American Society of Clinical Oncology
(J Clin Oncol)
Vol. 26
Issue 2
Pg. 218-24
(Jan 10 2008)
ISSN: 1527-7755 [Electronic] United States |
PMID | 18182664
(Publication Type: Journal Article, Multicenter Study)
|
Chemical References |
- Cytarabine
- Etoposide
- Melphalan
- Carmustine
|
Topics |
- Aged
- Antineoplastic Combined Chemotherapy Protocols
(therapeutic use)
- Carmustine
(administration & dosage)
- Combined Modality Therapy
- Cytarabine
(administration & dosage)
- Disease Progression
- Etoposide
(administration & dosage)
- Female
- Humans
- Immunoblastic Lymphadenopathy
(drug therapy, therapy)
- Male
- Melphalan
(administration & dosage)
- Middle Aged
- Neoplasm Recurrence, Local
- Proportional Hazards Models
- Remission Induction
- Retrospective Studies
- Stem Cell Transplantation
- Survival Analysis
- Transplantation Conditioning
- Treatment Outcome
|