Annals of Oncology 14:1768-1775, 2003
© 2003 European Society for Medical Oncology
Original Paper |
High-dose chemotherapy and autologous stem cell transplantation in peripheral T-cell lymphoma: the GEL-TAMO experience
1 Hospital Son Dureta, Palma de Mallorca; 2 Hospital Clinico Universitario, Salamanca; 3 Hospital Nuestra Señora de Aranzazu, San Sebastian; 4 Hospital 12 de Octubre, Madrid; 5 Hospital de la Santa Creu i Sant Pau, Barcelona; 6 Hospital Clinic i Provincial, Barcelona; 7 Hospital General de Jerez, Jerez de la Frontera; 8 Hospital de la Princesa, Madrid; 9 Institut Catala d’Oncologia, Barcelona; 10 Hospital de la Vall de Hebron, Barcelona; 11 Hospital Ramon y Cajal, Madrid; 12 Clinica Universitaria de Navarra, Pamplona; 13 Hospital Juan Canalejo, La Coruña; 14 Hospital Marques de Valdecilla, Santander, Spain
Received 7 July 2003; accepted 11 August 2003
Background:
T-cell immunophenotype constitutes an unfavorable prognostic factor in aggressive non-Hodgkin’s lymphomas. High-dose chemotherapy with autologous stem-cell rescue (HDC/ASCT) is the best salvage therapy for patients with aggressive B-cell lymphomas. However, results with this therapy in peripheral T-cell lymphoma (PTCL) are not well defined.
Patients and methods:
From January 1990 to December 1999, 115 patients with PTCL underwent HDC/ASCT inside the Grupo Español de Linfomas/Trasplante Autólogo de Médula Ósea (GEL-TAMO) registry. At diagnosis the median age was 41 years and 60% of patients presented with two or three risk factors from the adjusted International Prognostic Index (a-IPI). Thirty-two per cent of patients were transplanted in first complete response (CR), 62% in chemosensitive disease and 5% in refractory disease.
Results:
Eighty-six per cent of the patients attained a CR and 5% a partial response (PR). With a median follow-up of 37 months (range 1–133), overall survival (OS), time-to-treatment failure (TTF) and disease-free survival (DFS) at 5 years was 56%, 51% and 60%, respectively; for the 37 patients transplanted in first CR, OS and DFS at 5 years were 80% and 79%, respectively. Lactase dehydrogenase (LDH), a-IPI and disease status pre-transplant were associated with outcome.
Conclusions:
More than half of patients with chemosensitive disease who were transplanted are expected to be alive at 5 years. We confirm the utility of the pre-transplant IPI system in predicting outcome. Salvage treatment results with HDC/ASCT in PTCL are similar to those found in corresponding aggressive B-cell lymphomas.
Key words: autologous transplantation, GEL-TAMO, peripheral T-cell lymphoma
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