A prospective cohort study of patients with peripheral T‐cell lymphoma in the United States

Abstract

Background Long-term survival in patients with aggressive peripheral T-cell lymphoma (PTCL) is generally poor and there is no clear consensus on initial therapy used for these diseases. We analyzed treatment patterns and outcomes in a prospectively collected cohort of patients with a new diagnosis of nodal PTCL in the United States. Methods Comprehensive Oncology Measures for Peripheral T-cell Lymphoma Treatment (COMPLETE) is a prospective multicenter cohort study designed to identify the most common prevailing treatment patterns used for newly diagnosed PTCL patients in the United States. Patients with nodal PTCL and completed records on baseline characteristics and initial therapy were included in this analysis. All statistical tests were two-sided. Results Of a total of 499 patients enrolled, 256 (51.3%) had nodal PTCL and completed treatment records. Patients received as initial therapy: doxorubicin-containing regimens (41.8%), doxorubicin + etoposide-containing regimens (20.9%), other etoposide regimens (15.8%), other single agent or combination regimens (19.2%), and gemcitabine-containing regimens (2.1%). Survival was statistically significantly longer for patients who received doxorubicin (log-rank P = .03). After controlling for disease histology and International Prognostic Index, results showed a trend toward significance in mortality reduction in patients who received doxorubicin compared to those who did not (hazard ratio = 0.71, 95% confidence interval = 0.48 to 1.05, P = .09). Conclusion There is no clear standard of care in the treatment of PTCL in the United States. While efforts to improve front-line treatments are necessary, anthracyclines remain an important component of initial therapy of curative intent.

The role of autologous stem cell transplantation in patients with nodal peripheral T‐cell lymphomas in first complete remission: Report from COMPLETE, a prospective, multicenter cohort study

“…A total of 499 patients with PTCL were enrolled in COMPLETE over a period of 4 years between February 2010 and February 2014 from 56 academic and community centers. The characteristics of the patients enrolled in COMPLETE have been reported previously and are comparable to those of patients from the Surveillance, Epidemiology, and End Results program . The histology reports were reviewed by 5 independent hematopathologists .…”

“…Transplantation was not considered for the following reasons (as indicated by the treating physician): physician choice (55%), PTCL subtype (21%), patient age/comorbidities (14%), cost/insurance (3%), and others (18%). The majority of patients received an anthracycline‐containing regimen as the first‐line treatment . Various conditioning regimens were used for ASCT according to the institutional standards, although the combination of carmustine, etoposide, cytarabine, and melphalan (BEAM) or different variations of BEAM were most commonly used.…”

“…The characteristics of the patients enrolled in COMPLETE have been reported previously and are comparable to those of patients from the Surveillance, Epidemiology, and End Results program. 19 The histology reports were reviewed by 5 independent hematopathologists. 20 Before the start of the initial treatment, 18 patients were removed from the study, most commonly because they were lost to follow-up or did not meet the eligibility criteria.…”

“…The majority of patients received an anthracycline-containing regimen as the first-line treatment. 19 Various conditioning regimens were used for ASCT according to the institutional standards, although the combination of carmustine, etoposide, cytarabine, and melphalan (BEAM) or different variations of BEAM were most commonly used.…”

Single agents vs combination chemotherapy in relapsed and refractory peripheral T‐cell lymphoma: Results from the comprehensive oncology measures for peripheral T‐cell lymphoma treatment (COMPLETE) registry

“…Data collection for COMPLETE has been described elsewhere . In brief, de‐identified data were regularly uploaded onto the study server from each enrolling site by the treating physician.…”