Annals of Oncology Advance Access originally published online on January 17, 2007
Annals of Oncology 2007 18(4):652-657; doi:10.1093/annonc/mdl466
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© 2007 European Society for Medical Oncology
hematologic malignancies |
The results of consolidation with autologous stem-cell transplantation in patients with peripheral T-cell lymphoma (PTCL) in first complete remission: the Spanish Lymphoma and Autologous Transplantation Group experience
1 Hospital Universitario Son Dureta (Service of Oncology), Palma
2 Hospital de Valdecilla, Santander
3 Hospital Universitario Son Dureta (Service of Hematology), Palma
4 Hospital La Princesa, Madrid
5 Hospital de Jerez de la Frontera, Cádiz
6 Hospital Nuestra Señora de Aránzazu, San Sebastián
7 Clínica de Navarra, Pamplona
8 Hospital Xeral-Cies, Pontevedra
9 Hospital Clínico de Salamanca, Spain
* Correspondence to: Dr J. Rodríguez, Service of Oncology, University Hospital Son Dureta, Av/Andrea Doria 55, Palma de Mallorca 07014, Spain. Tel: +34-971-175000; Fax: +34-971-175500; E-mail: jrodriguez{at}hsd.es
Background: Peripheral T-cell lymphoma (PTCL) is a heterogeneous group of aggressive lymphomas associated with poor prognosis with standard chemotherapy. Consolidation with autologous stem-cell transplantation (ASCT) may improve survival. We present 74 patients transplanted in first complete response (CR) from the Spanish Lymphoma and Autologous Transplantation Group cooperative group.
Patients and methods: Median age was 46 years. Eighty-eight percent presented advanced (III–IV) Ann Arbor stage; 53% had B symptoms; 52% had high lactate dehydrogenase; 65% had two or three risk factors of the adjusted-International Prognostic Index; 58% presented a high Tumor score and in 14% more than two adverse factors of the Prognostic Index for peripheral T-cell lymphoma (PIT) were observed.
Results: With a median follow-up of 67 months from diagnosis, the 5-year overall survival (OS) was 68% and progression-free survival (PFS) reached 63%. The multivariate analysis showed that the only factor associated with a shorter OS and PFS was the presence of more than two risk factors from the PIT risk system.
Conclusions: In a retrospective study with a prolonged follow-up, consolidation with ASCT in CR patients who had presented unfavorable prognostic factors at diagnosis substantially increased the OS and PFS when compared with conventional chemotherapy. The PIT risk system identified 14% of patients without benefit from ASCT consolidation. Thus, other innovative therapies are still necessary in certain cases.
Key words: autologous stem-cell transplantation, complete response, consolidation, front-line, peripheral T-cell lymphoma
Received for publication October 30, 2006. Accepted for publication November 15, 2006.
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