A Systematic Review and Meta-Analysis of Front-line Anthracycline-Based Chemotherapy Regimens for Peripheral T-Cell Lymphoma

Abstract

Anthracycline-based chemotherapy remains standard treatment for peripheral T-cell lymphoma (PTCL) although its benefits have been questioned. We performed systematic literature review and meta-analyses examining the complete response (CR) and overall survival (OS) rates for patients with PTCL. The CR rate for PTCL patients ranged from 35.9% (95% CI 23.4–50.7%) for enteropathy-type T-cell lymphoma (ETTL) to 65.8% (95% CI 54.0–75.9%) for anaplastic large cell lymphoma (ALCL). The 5-year OS was 38.5% (95% CI 35.5–41.6%) for all PTCL patients and ranged from 20.3% (95% CI 12.5–31.2%) for ETTL to 56.5% (95% CI 42.8–69.2%) for ALCL. These data suggest that there is marked heterogeneity across PTCL subtypes in the benefits of anthracycline-based chemotherapy. While anthracyclines produce CR in half of PTCL patients, this yields reasonable 5-year OS for patients with ALCL but not for those with PTCL-NOS or ETTL. Novel agents and regimens are needed to improve outcomes for these patients.

Effect of immune modulation in relapsed peripheral T-cell lymphomas after post-allogeneic stem cell transplantation: a study by the Société Française de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC)

“…In addition to a high rate of primary chemo-refractory disease, the relapse rate reaches 40% after conventional chemotherapy with the CHOP regimen. 1 Conventional salvage therapies are also poorly effective, even if new molecules currently under investigation seem to be promising. The relapse rate after allo-SCT ranges from 15% to 49%, which is comparable to that seen after auto-SCT.…”

“…ACM 1 and SN 20 designed the study and wrote the paper; VL 2 and MB 2 performed the statistical analysis, VL 2 and MB 2 contributed to the analysis of the results, PC, DB, SV, AX, NF, NC, YB, NI, CEB, FS, IYA, PT, ED, TL, JYC, AH, SM, KB, MO, JOB, GG, NM, MM, TD, JHB, FR, RO, CJ contributed to the data collection.…”

“…Because PTCL is frequently resistant to standard chemotherapy, the prognosis is generally poor: the overall 5-year overall survival (OS) rate among patients treated with conventional chemotherapy ranges from 25% to 45%. 1 Autologous stem cell transplantation is frequently used in eligible patients but relapse is frequent, especially in the case of chemoresistance at transplantation. 2 Allogenic SCT (allo-SCT) is increasingly used as an alternative strategy, based on a potent graft-versus-lymphoma effect (GvL).…”

Critical appraisal of belinostat in the management of T-cell lymphoma – patient considerations

“…In 2011, a meta-analysis evaluated the use of anthracyclinebased chemotherapy for the treatment of PTCLs. 6 A total of 31 studies (13 prospective and 18 retrospective) involving 2,815 patients were included in this meta-analysis. The complete response (CR) rates ranged from 30% to 76% across the studies.…”

Autológ haemopoeticus őssejt-transzplantáció szerepe T-sejtes lymphomában. Magyar adatok

“…Világszerte leggyakrabban alkalmazott kezelési mód a CHOP (cyclophosphamid, doxorubicin, vincristin, metylprednisolon) kombinált kemoterápia [2]. Anth racyclintartalmú szer mindenképpen szükséges a kombinációba, ezekkel 40% körüli komplett remisszió érhető el [3]. Számos próbálkozás történt agresszívebb, egyéb kemoterápiás szert tartalmazó protokollok bevezetésére, azonban túlélési előnyt nem jelentettek [4].…”