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The impact of stem cell transplantation on the natural course of peripheral T-cell lymphoma: a real-world experience.
- Source :
-
Annals of Hematology . Jul2018, Vol. 97 Issue 7, p1241-1250. 10p. - Publication Year :
- 2018
-
Abstract
- The role of autologous stem cell transplantation (autoSCT) as consolidating treatment for peripheral T-cell lymphoma (PTCL) is unsettled. The aim of this analysis was to investigate the impact of autoSCT in the upfront setting by intent-to-treat and to study salvage strategies after relapse. Retrospective follow-up of all patients aged 18-70 years and treated at our institution for ALK-PTCL diagnosed between 2001 and 2014. Of 117 eligible patients, diagnosis was PTCL-NOS in 34, ALCL ALK- in 31, AITL in 28, and other PTCL in 24 patients. Disregarding 20 patients who received first-line treatment externally, upfront autoSCT was not intended in 34 due to comorbidity, higher age, low IPI, physician's decision or unknown reasons (nITT), while intent-to-transplant (ITT) was documented in 63 patients. ITT was not associated with significant benefits for 5-year progression-free survival (PFS) and overall survival (OS) with 46 and 23% in the ITT group vs. 42 and 25% in the nITT group, even after multivariate adjustment for confounders. Altogether, 91 of all 117 patients relapsed or progressed. Thirty-one patients managed to proceed to salvage allografting and achieved a 5-year OS of 52%. In contrast, all 7 patients receiving salvage autoSCT relapsed and died, and only 3 of the 51 patients not eligible for SCT salvage survived. In this study, a significant benefit of intending first-line autoSCT over non-transplant induction in patients with ALK-PTCL did not emerge. Most patients fail first-line treatment and have a poor outlook if salvage alloSCT cannot be performed. [ABSTRACT FROM AUTHOR]
- Subjects :
- *STEM cell transplantation
*T-cell lymphoma
*CANCER chemotherapy
*B cells
*RITUXIMAB
*ANTINEOPLASTIC agents
*AUTOGRAFTS
*COMBINED modality therapy
*COMPARATIVE studies
*HEMATOPOIETIC stem cell transplantation
*LONGITUDINAL method
*RESEARCH methodology
*MEDICAL cooperation
*PROGNOSIS
*RESEARCH
*EVALUATION research
*TREATMENT effectiveness
*PROPORTIONAL hazards models
*RETROSPECTIVE studies
*DISEASE progression
*SALVAGE therapy
*KAPLAN-Meier estimator
*CONFOUNDING variables
*THERAPEUTICS
Subjects
Details
- Language :
- English
- ISSN :
- 09395555
- Volume :
- 97
- Issue :
- 7
- Database :
- Academic Search Index
- Journal :
- Annals of Hematology
- Publication Type :
- Academic Journal
- Accession number :
- 129854869
- Full Text :
- https://doi.org/10.1007/s00277-018-3288-7