Role of up-front autologous stem cell transplantation in peripheral T-cell lymphoma for patients in response after induction: An analysis of patients from LYSA centers.
peripheral T-cell lymphoma; autologous stem-cell transplantation; propensity score matching; complete response; partial response; first line
Abstract :
[en] Background: Peripheral T-cell lymphoma (PTCL) remains a therapeutic challenge. Due to the rarity and the heterogeneity of PTCL, no consensus has been achieved regarding even the type of first-line treatment. The benefit of autologous stem-cell transplantation (ASCT) is, therefore, still intensely debated.
Patients and methods: In the absence of randomized trials addressing the role of ASCT, we performed a large multicentric retrospective study and used both a multivariate proportional hazard model and a propensity score matching approach to correct for sample selection bias between patients allocated or not to ASCT in intention-to-treat (ITT).
Results: Among 527 patients screened from 14 centers in France, Belgium and Portugal, a final cohort of 269 patients 65 years old with PTCL-not otherwise specified (NOS) (N¼78, 29%), angioimmunoblastic T-cell lymphoma (AITL) (N¼123, 46%) and anaplastic lymphoma kinase-positive anaplastic large cell lymphoma (ALK-ALCL) (N¼68, 25%) with partial (N¼52,
19%) or complete responses (N¼217, 81%) after induction was identified and information about treatment allocation was carefully collected before therapy initiation from medical records. One hundred and thirty-four patients were allocated to ASCT in ITT and 135 were not. Neither the Cox multivariate model (HR¼1.02; 95% CI: 0.69–1.50 for PFS and HR¼1.08; 95% CI: 0.68–
1.69 for OS) nor the propensity score analysis after stringent matching for potential confounding factors (logrank P¼0.90 and 0.66 for PFS and OS, respectively) found a survival advantage in favor of ASCT as a consolidation procedure for patients in response after induction. Subgroup analyses did not reveal any further difference for patients according to response status, stage disease or risk category.
Conclusions: The present data do not support the use of ASCT for up-front consolidation for all patients with PTCL-NOS, AITL, or ALK-ALCL with partial or complete response after induction.
Disciplines :
Hematology
Author, co-author :
Fossard, Gaëlle; Centre de recherche en cancérologie de Lyon
Broussais, Florence; Centre de recherche en cancérologie de Lyon
Coelho, Inês; Portuguese Institute of Oncology
Bailly, Sébastien; CHU de Clermont-Ferrand
Nicolas-Virelizier, Emmanuelle; Centre Leon Berard (Lyon)
Toussaint, Elise; CHU de Strasbourg
Lancesseur, Charles; CHU de Caen
Le Bras, Fabien; CHU Henri Mondor
WILLEMS, Evelyne ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service d'hématologie clinique
Role of up-front autologous stem cell transplantation in peripheral T-cell lymphoma for patients in response after induction: An analysis of patients from LYSA centers.
scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.
Bibliography
Swerdlow S, Campo E, Harris N. World Health Organization Classification of Tumors of Haematopoietic and Lymphoid Tissues. Lyon, France: IARC Press 2008.
Swerdlow SH, Campo E, Pileri SA et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood 2016; 127(20): 2375-2390.
Federico M, Rudiger T, Bellei M et al. Clinicopathologic characteristics of angioimmunoblastic T-cell lymphoma: analysis of the international peripheral T-cell lymphoma project. J Clin Oncol 2013; 31: 240-246.
Vose J, Armitage J, Weisenburger D, International T-cell Lymphoma Project. International peripheral T-cell and natural killer/T-cell lymphoma study: pathology findings and clinical outcomes. J Clin Oncol 2008; 26: 4124-4130.
Lunning MA, Vose JM. Angioimmunoblastic T-cell lymphoma: the many-faced lymphoma. Blood 2017; 129(9): 1095-1102.
de Leval L, Parrens M, Le Bras F et al. Angioimmunoblastic T-cell lymphoma is the most common T-cell lymphoma in two distinct French information data sets. Haematologica 2015; 100(9): e361-e364.
Moskowitz AJ, Lunning MA, Horwitz SM. How I treat the peripheral T-cell lymphomas. Blood 2014; 123(17): 2636-2644.
Simon A, Peoch M, Casassus P et al. Upfront VIP-reinforced-ABVD (VIP-rABVD) is not superior to CHOP/21 in newly diagnosed peripheral T cell lymphoma. Results of the randomized phase III trial GOELAMSLTP95. Br J Haematol 2010; 151(2): 159-166.
Ellin F, Landstrom J, Jerkeman M, Relander T. Real-world data on prognostic factors and treatment in peripheral T-cell lymphomas: a study from the Swedish Lymphoma Registry. Blood 2014; 124(10): 1570-1577.
Schmitz N, Trumper L, Ziepert M et al. Treatment and prognosis of mature T-cell and NK-cell lymphoma: an analysis of patients with T-cell lymphoma treated in studies of the German High-Grade Non-Hodgkin Lymphoma Study Group. Blood 2010; 116(18): 3418-3425.
Abouyabis AN, Shenoy PJ, Sinha R et al. A systematic review and metaanalysis of front-line anthracycline-based chemotherapy regimens for peripheral T-cell lymphoma. ISRN Hematol 2011; 2011: 623924.
Perrone G, Giulia P, Corradini P. Autologous stem cell transplantation for T-cell lymphomas. Semin Hematol 2014; 51(1): 59-66.
Jethwa KD, Bishton MJ, Fox CP. The role of high-dose chemotherapy and autologous stem cell transplant for treatment-naive patients with peripheral T-cell lymphoma: a systematic review of the literature. Br J Haematol 2016.
Schmitz N, de Leval L. How I manage peripheral T-cell lymphoma, not otherwise specified and angioimmunoblastic T-cell lymphoma: current practice and a glimpse into the future. Br J Haematol 2017; 176(6): 851-866.
Cheson BD, Horning SJ, Coiffier B et al. Report of an international workshop to standardize response criteria for non-Hodgkin's lymphomas. NCI Sponsored International Working Group. J Clin Oncol 1999; 17: 1244.
Kaplan E, Meier P. Non parametric estimation from incomplete observations. J Am Stat Assoc 1958; 53(282): 457-481.
Cox DR. Regression models and life tables. J Royal Stat Soc Series B 1972; 34: 187-220.
d'Amore F, Gaulard P, Trumper L et al. Peripheral T-cell lymphomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and followup. Ann Oncol 2015; 26(Suppl 5): v108-v115.
Kharfan-Dabaja MA, Kumar A, Ayala E et al. Clinical practice recommendations on indication and timing of hematopoietic cell transplantation in mature T cell and NK/T cell lymphomas: an international collaborative effort on behalf of the Guidelines Committee of the American Society for Blood and Marrow Transplantation. Biol Blood Marrow Transplant 2017; 23(11):1826-1838.
Cederleuf H, Hjort Jakobsen L, Ellin F et al. Outcome of peripheral T-cell lymphoma in first complete remission: a Danish-Swedish populationbased study. Leuk Lymphoma 2017; 58(12): 2815-2823.
Abramson JS, Feldman T, Kroll-Desrosiers AR et al. Peripheral T-cell lymphomas in a large US multicenter cohort: prognostication in the modern era including impact of frontline therapy. Ann Oncol 2014; 25(11): 2211-2217.
Mercadal S, Briones J, Xicoy B et al. Intensive chemotherapy (high-dose CHOP/ESHAP regimen) followed by autologous stem-cell transplantation in previously untreated patients with peripheral T-cell lymphoma. Ann Oncol 2008; 19(5): 958-963.
Yam C, Landsburg DJ, Nead KT et al. Autologous stem cell transplantation in first complete remission may not extend progression-free survival in patients with peripheral T cell lymphomas. Am J Hematol 2016; 91(7): 672-676.
Wilhelm M, Smetak M, Reimer P et al. First-line therapy of peripheral Tcell lymphoma: extension and long-term follow-up of a study investigating the role of autologous stem cell transplantation. Blood Cancer J 2016; 6(7): e452.
Kitahara H, Maruyama D, Maeshima AM et al. Prognosis of patients with peripheral T cell lymphoma who achieve complete response after CHOP/CHOP-like chemotherapy without autologous stem cell transplantation as an initial treatment. Ann Hematol 2017; 96(3): 411-420.
Burudpakdee C, Lin HM, Wang W et al. Clinical and economic burden of peripheral T-cell lymphoma in commercially insured patients in the United States: findings using real-world claims data. J Med Econ 2016; 19(10): 965-972.
Similar publications
Sorry the service is unavailable at the moment. Please try again later.
This website uses cookies to improve user experience. Read more
Save & Close
Accept all
Decline all
Show detailsHide details
Cookie declaration
About cookies
Strictly necessary
Performance
Strictly necessary cookies allow core website functionality such as user login and account management. The website cannot be used properly without strictly necessary cookies.
This cookie is used by Cookie-Script.com service to remember visitor cookie consent preferences. It is necessary for Cookie-Script.com cookie banner to work properly.
Performance cookies are used to see how visitors use the website, eg. analytics cookies. Those cookies cannot be used to directly identify a certain visitor.
Used to store the attribution information, the referrer initially used to visit the website
Cookies are small text files that are placed on your computer by websites that you visit. Websites use cookies to help users navigate efficiently and perform certain functions. Cookies that are required for the website to operate properly are allowed to be set without your permission. All other cookies need to be approved before they can be set in the browser.
You can change your consent to cookie usage at any time on our Privacy Policy page.
