Impact of High-Dose Chemotherapy on Peripheral T-Cell Lymphomas

Rodríguez, José A.; Munsell, Mark F.; Yazji, S.; Hagemeister, Fredrick B.; Younes, Anas; Andersson, Börje S.; Giralt, Sergío; Gajewski, J.; Lima, Marcos de; Couriel, Daniel R.; Romaguera, Jorge; Cabanillas, Fernando; Champlin, Richard E.; Khouri, Issa F.

doi:10.1200/jco.2001.19.17.3766

Cited by 140 publications

(100 citation statements)

References 20 publications

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“…However, the numbers of patients in the various studies are relatively small. [6][7][8] These results are similar to a comparable group of patients with B-cell lymphomas. 7,9 The role of allogeneic stem cell transplantation (Allo-SCT) for the treatment of relapsed lymphoma remains unclear, although it has been demonstrated to be an effective salvage strategy in selected patients.…”

Section: Introductionsupporting

confidence: 77%

“…[2][3][4][5] Patients with PTCL treated with conventionaldose chemotherapy alone, demonstrated a 5-year survival of 38% (95% confidence interval (CI), 35-54%) compared to patients with B-cell disease who demonstrated a 5-year survival of 63% (95% CI 53-73%, P ¼ 0.001), a difference that was maintained when stratified using the IPI and MD Anderson tumour score. 4,6 Cumulative experience has shown that high-dose chemotherapy is an effective salvage therapy in B-cell malignant lymphoma. 5 However, data examining the impact of high-dose chemotherapy with autologous haemopoietic stem cell rescue in PTCL are limited.…”

Section: Introductionmentioning

confidence: 99%

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The role of high-dose therapy and stem cell rescue in the management of T-cell malignant lymphomas: a BSBMT and ABMTRR study

Feyler

Prince

Pearce

et al. 2007

Bone Marrow Transplant

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Peripheral T-cell lymphomas (PTCL) are a rare and heterogeneous subset of lymphomas with a poorer prognosis compared with B-cell lymphomas. We conducted a retrospective study of 82 patients who received high-dose therapy for PTCL (autologous SCT (ASCT) N ¼ 64; allogeneic SCT (Allo-SCT) N ¼ 18). With a median follow-up from ASCT of 37 months from transplant, 33 patients were alive; 20 died of progressive disease, 10 died from non-relapse mortality (NRM) with 1 unknown cause. Three-year overall survival (OS) and progression-free survival (PFS) were 53% (95% confidence interval (CI) 42, 67) and 50% (95% CI 39, 64), respectively. Factors significantly affecting OS and PFS on univariate analysis were histological subtype and chemotherapy sensitivity. In a multivariate analysis, the only factor with significant impact was chemotherapy sensitivity. After a median follow-up from Allo-SCT of 57 months, five patients were alive; five died of progressive disease and eight died from NRM. The 3-year OS and PFS were 39% (95% CI 22, 69) and 33% (95% CI 17, 64), respectively, and the 3-year relapse rate was 28% (95% CI 6, 50). These results demonstrate that high-dose chemotherapy with autologous stem cell rescue has a substantial role in the management of T-cell lymphoma. The use of full-intensity allogeneic transplantation is limited by high transplant-related mortality, and exploration of reduced intensity regimens is warranted.

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Section: Introductionsupporting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

The role of high-dose therapy and stem cell rescue in the management of T-cell malignant lymphomas: a BSBMT and ABMTRR study

Feyler

Prince

Pearce

et al. 2007

Bone Marrow Transplant

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“…15,35,36 Similarly, Corradini et al 35 reported 17 patients with relapsed or refractory disease who underwent a reduced intensity allogeneic procedure. The authors found an impressive OS of 80% and PFS of 60% at 3 years.…”

Section: Allo-hsct For Ptclmentioning

confidence: 99%

Hematopoietic SCT for peripheral T-cell lymphoma

Gutiérrez

Caballero

Perez-Manga

et al. 2008

Bone Marrow Transplant

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Results of conventional chemotherapy for high-risk peripheral T-cell lymphoma (PTCL) are poor compared with those for their aggressive B-cell counterparts. We aim to review the current data on the use of hematopoietic SCT in these patients in both frontline and salvage settings. With respect to autologous SCT (ASCT), conclusions from retrospective studies are that ASCT in the salvage setting is as useful in PTCL as in aggressive B-cell lymphomas and also that consolidation in first complete response of high-risk patients has very good results when compared with conventional chemotherapy (with long-term PFS higher than 50%). From first frontline prospective clinical trials, it appears that ASCT is feasible and has a low TRM (o5%); consolidation in first complete response is associated with a very good outcome; around 25% of patients do not undergo ASCT due mainly to disease progression; new approaches aimed at increasing the number of chemosensitive patients should be found. Furthermore, 25-30% of patients deemed complete responders post transplant still relapse afterward. For all these mainly chemoresistant patients, there is preliminary evidence that allogeneic SCT (Allo-SCT) may produce a plateau in survival curves (with long-term PFS around 50%), which indicates a graft-versus-PTCL effect. For this reason, Allo-SCT procedures are the object of ongoing clinical trials.

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“…5 On the other hand, the outcomes were equivalent in patients treated with high-dose sequential chemotherapy followed by autologous transplantation (ASCT). [25][26][27][28][29][30] It has been reported that there is marked variability in the 5-year relative survival rate across PTCL subtypes, and that there has been no clear improvement in survival among PTCL patients over time. 31 This finding is in sharp contrast to the improvement in OS seen for B-cell NHLs over the same time period, [18][19][20][21] which is due mainly to advances in therapy, particularly the addition of immunotherapy using anti-CD20 rituximab.…”

Section: Figmentioning

confidence: 99%

Comparison of Long-Term Clinical Outcomes of CHOP Chemotherapy between Japanese Patients with Nodal Peripheral T-Cell Lymphomas and Those with Diffuse Large B-Cell Lymphoma in the Study Group of the Tohoku Hematology Forum

Akagi

Takahashi

Yamaguchi

et al. 2011

J Clin Exp Hematopathol

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To clarify the clinical outcome of peripheral T-cell lymphomas (PTCLs), we conducted a retrospective review comparing the outcomes of patients with PTCL (nodal peripheral T-cell lymphoma, unspecified, n＝34 ; angioimmunoblastic T-cell lymphoma, n＝12) to those with diffuse large B-cell lymphoma (DLBCL, n＝48). All patients received CHOP-based chemotherapy without rituximab. PTCL patients presented at a more advanced clinical stage (91% vs. 65%, P ＜ 0.002) with a poorer performance status (26% vs. 17%, P＜0.002) than DLBCL patients. The complete response rate among PTCL patients was significantly lower than among DLBCL patients (39% vs. 67%, P＜0.008), as was the 3-year overall survival rate (26% vs. 50%, P＝0.005), and Cox multivariate analysis revealed immunophenotype, performance status, and extranodal site involved to be significantly associated with shorter overall survival (P＝0.045, P＝0.007, and P＝0.034, respectively). Our findings suggest that PTCL patients tend to have a poor prognosis associated with several initial risk factors. Moreover, the T-cell phenotype itself appears to have a significant impact on overall survival. Thus, standard CHOP chemotherapy may be inadequate for PTCLs, especially in patients with high-risk factors. The development of newly stratified therapies for the treatment of PTCLs would be highly desirable. 〔J Clin Exp Hematopathol 51(1) : 29-35, 2011〕

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Impact of High-Dose Chemotherapy on Peripheral T-Cell Lymphomas

Cited by 140 publications

References 20 publications

The role of high-dose therapy and stem cell rescue in the management of T-cell malignant lymphomas: a BSBMT and ABMTRR study

The role of high-dose therapy and stem cell rescue in the management of T-cell malignant lymphomas: a BSBMT and ABMTRR study

Hematopoietic SCT for peripheral T-cell lymphoma

Comparison of Long-Term Clinical Outcomes of CHOP Chemotherapy between Japanese Patients with Nodal Peripheral T-Cell Lymphomas and Those with Diffuse Large B-Cell Lymphoma in the Study Group of the Tohoku Hematology Forum

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