1. The role of high dose chemotherapy and autologous stem-cell transplantation in peripheral T-cell lymphoma: a review of the literature and new perspectives
- Author
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Amy S. Kimball and Jean Yared
- Subjects
Oncology ,medicine.medical_specialty ,medicine.medical_treatment ,Population ,Lymphoma, T-Cell ,Transplantation, Autologous ,Autologous stem-cell transplantation ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,T-cell lymphoma ,Humans ,Radiology, Nuclear Medicine and imaging ,education ,Anaplastic large-cell lymphoma ,Randomized Controlled Trials as Topic ,education.field_of_study ,Chemotherapy ,Dose-Response Relationship, Drug ,business.industry ,General Medicine ,medicine.disease ,Combined Modality Therapy ,Peripheral T-cell lymphoma ,Lymphoma ,Surgery ,Transplantation ,business ,Stem Cell Transplantation - Abstract
Peripheral T-cell lymphoma (PTCL) is a heterogeneous group of non-Hodgkin's lymphoma that carries, except for ALK-positive anaplastic large cell lymphoma, a poor prognosis. Only a third of patients live 5years past diagnosis. The incidence of PTCL has been increasing during the last two decades. In recent years, there was a rising interest in PTCL manifested by the abundance of publications dedicated exclusively to this disease. The international T-cell lymphoma project was formed with an aim of unifying efforts towards a better understanding of the diagnosis and management of this disease. Given the poor outcomes of PTCL patients, high-dose chemotherapy and autologous stem-cell transplantation (HDT/ASCT) have been used in the up-front and salvage settings, with different success rates. However, there are no prospective randomized controlled trials addressing the role of HDT/ASCT in a PTCL-restricted population. This article critically reviews the data available from the retrospective and prospective studies addressing this topic. We will emphasize the favorable prognostic factors of HDT/ASCT such as a solid remission at the time of transplantation, a chemotherapy sensitive disease and a low prognostic index score. As novel agents and new therapeutic strategies are introduced, there is a continued need for prospective randomized trials to define the optimal use of HDT/ASCT in managing PTCL.
- Published
- 2012