The impact of stem cell transplantation on the natural course of peripheral T-cell lymphoma

• Verfasst von: Rohlfing, Sarah [VerfasserIn]
• Verfasst von: Dietrich, Sascha [VerfasserIn]
• Verfasst von: Witzens-Harig, Mathias [VerfasserIn]
• Verfasst von: Hegenbart, Ute [VerfasserIn]
• Verfasst von: Schönland, Stefan [VerfasserIn]
• Verfasst von: Luft, Thomas [VerfasserIn]
• Verfasst von: Ho, Anthony Dick [VerfasserIn]
• Verfasst von: Dreger, Peter [VerfasserIn]
• Titel: The impact of stem cell transplantation on the natural course of peripheral T-cell lymphoma
• Titelzusatz: a real-world experience
• Verf.angabe: Sarah Rohlfing, Sascha Dietrich, Mathias Witzens-Harig, Ute Hegenbart, Stefan Schönland, Thomas Luft, Anthony D. Ho, Peter Dreger
• E-Jahr: 2018
• Jahr: 16 March 2018
• Umfang: 10 S.
• Fussnoten: Gesehen am 05.04.2019
• Titel Quelle: Enthalten in: Annals of hematology
• Ort Quelle: Berlin : Springer, 1955
• Jahr Quelle: 2018
• Band/Heft Quelle: 97(2018), 7, Seite 1241-1250
• ISSN Quelle: 1432-0584
• DOI: doi:10.1007/s00277-018-3288-7
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Adults
• Sach-SW: Antineoplastic combined chemotherapy protocols
• Sach-SW: Hematopoietic stem cell transplantation
• Sach-SW: Peripheral T-cell lymphoma
• Sach-SW: Salvage therapy
• Sach-SW: Treatment outcome
• K10plus-PPN: 1662905165

Abstract

The role of autologous stem cell transplantation (autoSCT) as consolidating treatment for peripheral T-cell lymphoma (PTCL) is unsettled. The aim of this analysis was to investigate the impact of autoSCT in the upfront setting by intent-to-treat and to study salvage strategies after relapse. Retrospective follow-up of all patients aged 18-70 years and treated at our institution for ALK-PTCL diagnosed between 2001 and 2014. Of 117 eligible patients, diagnosis was PTCL-NOS in 34, ALCL ALK− in 31, AITL in 28, and other PTCL in 24 patients. Disregarding 20 patients who received first-line treatment externally, upfront autoSCT was not intended in 34 due to comorbidity, higher age, low IPI, physician’s decision or unknown reasons (nITT), while intent-to-transplant (ITT) was documented in 63 patients. ITT was not associated with significant benefits for 5-year progression-free survival (PFS) and overall survival (OS) with 46 and 23% in the ITT group vs. 42 and 25% in the nITT group, even after multivariate adjustment for confounders. Altogether, 91 of all 117 patients relapsed or progressed. Thirty-one patients managed to proceed to salvage allografting and achieved a 5-year OS of 52%. In contrast, all 7 patients receiving salvage autoSCT relapsed and died, and only 3 of the 51 patients not eligible for SCT salvage survived. In this study, a significant benefit of intending first-line autoSCT over non-transplant induction in patients with ALK-PTCL did not emerge. Most patients fail first-line treatment and have a poor outlook if salvage alloSCT cannot be performed.