Predictive capacity of the International Prognostic Factor Index in patients with peripheral T-cell lymphoma.

Ansell, Stephen M.; Habermann, Thomas M.; Kurtin, Paul J.; Witzig, Thomas E.; Chen, Michael G.; Li, Chin Y.; Inwards, David J.; Colgan, Joseph P.

doi:10.1200/jco.1997.15.6.2296

Cited by 138 publications

(78 citation statements)

References 14 publications

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“…Later, two studies have confirmed that the IPI can also be applied for PTCL. 2,36 However, the IPI was prepared for patients treated with conventional therapy, and might therefore not be relevant for patients who receive HDT. Other factors independent of IPI may have an impact on prognosis.…”

Section: Discussionmentioning

confidence: 99%

High-dose therapy with autologous stem cell transplantation in patients with peripheral T cell lymphomas

Blystad

Enblad

Kvaløy

et al. 2001

Bone Marrow Transplant

127

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Summary:Peripheral T cell lymphomas (PTCL) have a poorer prognosis after conventional treatment than do highgrade B cell lymphomas. The place for high-dose therapy (HDT) with autologous stem cell support in these patients is still not clear. Forty patients, 10 women and 30 men, median age 41.5 years (range 16-61) with PTCL were treated with HDT and autologous stem cell support at The Norwegian Radium Hospital, Oslo, Norway and The University Hospital, Uppsala, Sweden, between February 1990 and September 1999. The histologic subtypes were: PTCL unspecified, 20 patients; intestinal, two patients; angioimmunoblastic (AILD), two patients; angiocentric, two patients and anaplastic large cell lymphoma (ALCL), 14 patients. All patients had chemosensitive disease and had received anthracycline-containing regimens prior to transplantation. At the time of HDT, 17 patients were in first PR or CR and 23 were in second or third PR or CR. Conditioning regimens were BEAM in 15 patients, BEAC in 14 patients, cyclophosphamide and total body irradiation (TBI) in eight patients, BEAC, without etoposide and TBI in one patient and mitoxantrone and melphalan in two patients. There were three (7.5%) treatment-related deaths. The estimated overall survival (OS) at 3 years was 58%, the event-free survival (EFS) 48% and the relapse-free survival (RFS) 56%, with a median followup of 36 months (range 7-100) for surviving patients. The patients with ALCL tended to have a better prognosis compared to those with other PTCL subtypes, OS 79% vs 44%, respectively. In conclusion, patients with chemosensitive PTCL who are failing to achieve CR with first-line chemotherapy or are in relapse can successfully be treated with HDT and autologous stem cell support. Bone Marrow Transplantation (2001) 27, 711-716.

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Section: Discussionmentioning

confidence: 99%

High-dose therapy with autologous stem cell transplantation in patients with peripheral T cell lymphomas

Blystad

Enblad

Kvaløy

et al. 2001

Bone Marrow Transplant

127

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“…IPI score was shown to be relevant in other peripheral T cell lymphomas. 57,58 These studies analyzed patients with PTCL-NOS and AILT together, however, and the latter were in minority. Also, the IPI score was not a significant predictor of survival in the international lymphoma classification project for 17 cases of AILT, but the prognostic power increased for all cases of nodal peripheral T cell lymphoma as a group after AILT was excluded.…”

Section: Clinicopathologic Correlationmentioning

confidence: 99%

Angioimmunoblastic T cell lymphoma is derived from mature T‐helper cells with varying expression and loss of detectable CD4

Lee

Rüdiger

Odenwald

et al. 2002

Intl Journal of Cancer

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Angioimmunoblastic T cell lymphoma (AILT) is Key words: angioimmunoblastic T-cell lymphoma; immunohistochemistry; double labeling; clinicopathologic correlationAngioimmunoblastic lymphadenopathy with dysproteinemia was originally described by various groups 1-3 as a systemic lymphoproliferative disorder characterized by generalized lymphadenopathy, hepatosplenomegaly, fever, skin rash, anemia and immunologic abnormalities. Histologically, the lymph node structure is diffusely effaced by a hypocellular infiltrate including a mixture of small, medium-sized and large atypical lymphoid cells, plasma cells, eosinophils and histiocytes and a proliferation of high endothelial venules. 4 For some years it could not be clarified whether the disease should be considered a lymphoma 1,5,6 or an abnormal hyperimmune reaction, 2,4 because the fatal outcome was mostly attributed to severe infection rather than lymphoproliferation. 2,4 Subsequent studies, however, showed evidence of a clonal process demonstrating chromosomal abnormalities characteristic for T cell lymphoma 7-9 or a clonal rearrangement of T cell receptor genes. 10 -16 Based on these and immunophenotypic studies, the disease was incorporated into the updated Kiel classification of non-Hodgkin's lymphoma as "T cell lymphoma of angioimmunoblastic type". 17 Angioimmunoblastic lymphoma (AILT) has also been recognized by the REAL 18 and the World Health Organization (WHO) classification 19 as a separate disease entity of peripheral T cell lymphoma (PTCL). A morphological variant, AILT with hyperplastic germinal centers has been described recently. 20 It remains controversial whether the disease represents a homogeneous entity or should be divided into a preneoplastic and a neoplastic phase because some cases lack definite cytologic atypia and approximately 20 -30% of AILT showed no obvious evidence of clonality. [12][13][14][15][21][22][23][24][25] Criteria to predict an indolent clinical course have been proposed and were based on the absence of clear cells and lack of clonal T cell receptor gene rearrangement. 6,12,13,26 -29 Based on clinical data, others suggested the presence of clustered or sheet-like proliferations of immunoblasts or pale cells of T cell nature as a distinguishing criterion for AILD-like T cell lymphoma from reactive angioimmunoblastic lymphadenopathy. 6,28 The predictive value of these prognostic factors has not been settled so far.Ongoing research on AILT has also focused on the functional immunophenotype of putative tumor cells. These investigations proved to be rather difficult because of the morphologic heterogeneity of the cellular composition in AILT. Additionally, the nuclear morphology is not well preserved in frozen tissue sections. Although in most series the majority of cases seemed to be derived from CD4ϩ T cells, a minority of tumors was regarded to be CD8 ϩ . 12,13,16,20,23,24,27,30 -39 . In some studies, a considerable number of T cells was thought to be part of the reactive inflammatory background infiltrate of T cell lympho...

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“…Some retrospective analyses have shown comparable outcomes for relapsed T-and B-cell lymphoma following ASCT. The IPI score has been implicated as a prognostic factor following conventional therapy for PTCL 3,5,12 and may be relevant after high-dose therapy, as may serum LDH alone. 13 Similarly, disease status at the time of transplant may predict long-term outcome.…”

Section: Discussionmentioning

confidence: 99%

Autologous hematopoietic stem cell transplantation in peripheral T-cell lymphoma using a uniform high-dose regimen

Smith

Bolwell

Rybicki

et al. 2007

Bone Marrow Transplant

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The role of high-dose therapy and autologous stem cell transplantation (ASCT) for patients with peripheral T-cell lymphoma (PTCL) is poorly defined. Comparisons of outcomes between PTCL and B-cell non-Hodgkin's lymphoma (NHL) have yielded conflicting results, in part due to the rarity and heterogeneity of PTCL. Some retrospective studies have found comparable survival rates for patients with T-and B-cell NHL. In this study, we report our single-center experience of ASCT over one decade using a uniform chemotherapy-only high-dose regimen. Thirty-two patients with PTCL-unspecified (PTCL-u; 11 patients) and anaplastic large-cell lymphoma (21 patients) underwent autologous stem cell transplant, mostly for relapsed or refractory disease. The preparative regimen consisted of busulfan, etoposide and cyclophosphamide. Kaplan-Meier 5-year overall survival (OS) and relapse-free survival (RFS) are 34 and 18%, respectively. These results suggest a poor outcome for patients with PTCL after ASCT, and new therapies for T-cell lymphoma are needed.

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Predictive capacity of the International Prognostic Factor Index in patients with peripheral T-cell lymphoma.

Abstract: The International Prognostic Factor Index, which significantly predicts outcome in patients with aggressive/intermediate-grade B-cell lymphomas, has similar prognostic importance in patients with PTCL.

Cited by 138 publications

References 14 publications

High-dose therapy with autologous stem cell transplantation in patients with peripheral T cell lymphomas

High-dose therapy with autologous stem cell transplantation in patients with peripheral T cell lymphomas

Angioimmunoblastic T cell lymphoma is derived from mature T‐helper cells with varying expression and loss of detectable CD4

Autologous hematopoietic stem cell transplantation in peripheral T-cell lymphoma using a uniform high-dose regimen

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