nach oben

Erschienen in:

01.06.2007 | Original Article

High-dose chemotherapy and autologous stem cell transplantation for peripheral T-cell lymphoma: complete response at transplant predicts survival

verfasst von: Min Kyoung Kim, Shin Kim, Sung Sook Lee, Sun Jin Sym, Dae Ho Lee, Seongsoo Jang, Chan Jeong Park, Hyun Sook Chi, Jooryung Huh, Cheolwon Suh

Erschienen in: Annals of Hematology | Ausgabe 6/2007

Einloggen, um Zugang zu erhalten

Abstract

Although the role of high dose chemotherapy (HDT) and autologous stem cell transplantation (ASCT) in the treatment of aggressive lymphoma has been established in several large prospective studies, its effectiveness in patients with peripheral T cell lymphoma (PTCL) has not been defined. We aimed to evaluate the efficacy of HDT and ASCT and prognostic factors for survival in patients with PTCL. We retrospectively analyzed the results of 40 PTCL patients treated with HDT and ASCT at Asan Medical Center between January 1995 and December 2005. Twenty patients had PTCL-U (peripheral T cell lymphoma, unspecified), 10 had extranodal natural killer/T cell lymphoma, 5 had anaplastic large cell lymphoma, 3 had angioimmunoblastic T cell lymphoma, 1 had hepatosplenic γσ T cell lymphoma, and 1 had disseminated mycosis fungoides. Disease status at transplant was complete response (CR)1 in 3 patients, CR2 or greater in 8, partial remission in 25, and refractory in 4. At a median follow-up of 16 months (range, 5 to 135 months) for surviving patients, the median overall survival (OS) was 11.5 months and the 1-year probability of survival was 46.1%. The median event free survival (EFS) was 3.6 months (95% confidence interval, 2.5 to 4.8 months). Ten patients (25%) remain alive without evidence of disease. The median OS of 11 patients with CR at ASCT was not reached; of these, 7 patients (63.6%) were alive with CR. In multivariate analysis, CR at ASCT was a prognostic factor for EFS (P = 0.025) and OS (P = 0.027) and normal lactate dehydrogenase (LDH) at ASCT was a prognostic factor for improved OS (P = 0.025). Chemosensitive patients with PTCL who achieved CR before ASCT seem to benefit from HDT and ASCT. Pretransplant values of LDH had potential to predict the survival.

A clinical evaluation of the International Lymphoma Study Group classification of non-Hodgkin’s lymphoma (1997) The Non-Hodgkin’s Lymphoma Classification Project. Blood 89:3909–3918

Armitage JO, Greer JP, Levine AM, Weisenburger DD, Formenti SC, Bast M, Conley S, Pierson J, Linder J, Cousar JB, Nathwani BN (1989) Peripheral T-cell lymphoma. Cancer 63:158–163PubMedCrossRef

Kim WS, Song SY, Ahn YC, Ko YH, Baek CH, Kim DY, Yoon SS, Lee HG, Kang WK, Lee HJ, Park CH, Park K (2001) CHOP followed by involved field radiation: is it optimal for localized nasal natural killer/T-cell lymphoma? Ann Oncol 12:349–352PubMedCrossRef

Lopez-Guillermo A, Cid J, Salar A, Lopez A, Montalban C, Castrillo JM, Gonzalez M, Ribera JM, Brunet S, Garcia-Conde J, Fernandez de Sevilla A, Bosch F, Montserrat E (1998) Peripheral T-cell lymphomas: initial features, natural history, and prognostic factors in a series of 174 patients diagnosed according to the R.E.A.L. Classification. Ann Oncol 9:849–855PubMedCrossRef

Philip T, Guglielmi C, Hagenbeek A, Somers R, Van der Lelie H, Bron D, Sonneveld P, Gisselbrecht C, Cahn JY, Harousseau JL, Coiffier B, Biron P, Mandelli F, Chauvin F (1995) Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non-Hodgkin’s lymphoma. N Engl J Med 333:1540–1545PubMedCrossRef

Haioun C, Lepage E, Gisselbrecht C, Salles G, Coiffier B, Brice P, Bosly A, Morel P, Nouvel C, Tilly H, Lederlin P, Sebban C, Briere J, Gaulard P, Reyes F (2000) Survival benefit of high-dose therapy in poor-risk aggressive non-Hodgkin’s lymphoma: final analysis of the prospective LNH87-2 protocol—a groupe d’Etude des lymphomes de l’Adulte study. J Clin Oncol 18:3025–3030PubMed

Blystad AK, Enblad G, Kvaloy S, Berglund A, Delabie J, Holte H, Carlson K, Kvalheim G, Bengtsson M, Hagberg H (2001) High-dose therapy with autologous stem cell transplantation in patients with peripheral T cell lymphomas. Bone Marrow Transplant 27:711–716PubMedCrossRef

Kahl C, Leithauser M, Wolff D, Steiner B, Hartung G, Casper J, Freund M (2002) Treatment of peripheral T-cell lymphomas (PTCL) with high-dose chemotherapy and autologous or allogeneic hematopoietic transplantation. Ann Hematol 81:646–650PubMedCrossRef

Rodriguez J, Munsell M, Yazji S, Hagemeister FB, Younes A, Andersson B, Giralt S, Gajewski J, de Lima M, Couriel D, Romaguera J, Cabanillas FF, Champlin RE, Khouri IF (2001) Impact of high-dose chemotherapy on peripheral T-cell lymphomas. J Clin Oncol 19:3766–3770PubMed

10.

Milpied N, Deconinck E, Gaillard F, Delwail V, Foussard C, Berthou C, Gressin R, Lucas V, Colombat P, Harousseau JL (2004) Initial treatment of aggressive lymphoma with high-dose chemotherapy and autologous stem-cell support. N Engl J Med 350:1287–1295PubMedCrossRef

11.

Harris NL, Jaffe ES, Stein H, Banks PM, Chan JK, Cleary ML, Delsol G, De Wolf-Peeters C, Falini B, Gatter KC, Grogan TM, Isaacson PG, Knowles DM, Mason DY, Muller-Hermelink HK, Pileri S, Piris MA, Ralfkiaer E, Warnke RA (1994) A revised European–American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group. Blood 84:1361–1392PubMed

12.

Jaffe ES, Harris NL, Stein H, Vardiman JW (2001) Pathology and genetics of tumours of haematopoietic and lymphoid tissues. World Health Organization classification of tumours. IARC, Lyon

13.

A predictive model for aggressive non-Hodgkin’s lymphoma (1993) The international non-Hodgkin’s lymphoma prognostic factors project. N Engl J Med 329:987–994CrossRef

14.

Miller AB, Hoogstraten B, Staquet M, Winkler A (1981) Reporting results of cancer treatment. Cancer 47:207–214PubMedCrossRef

15.

Rodriguez J, Caballero MD, Gutierrez A, Marin J, Lahuerta JJ, Sureda A, Carreras E, Leon A, Arranz R, Fernandez de Sevilla A, Zuazu J, Garcia-Larana J, Rifon J, Varela R, Gandarillas M, San Miguel J, Conde E (2003) High-dose chemotherapy and autologous stem cell transplantation in peripheral T-cell lymphoma: the GEL–TAMO experience. Ann Oncol 14:1768–1775PubMedCrossRef

16.

Rodriguez J, Caballero MD, Gutierrez A, Gandarillas M, Sierra J, Lopez-Guillermo A, Sureda A, Zuazu J, Marin J, Arranz R, Carreras E, Leon A, De Sevilla AF, San Miguel JF, Conde E (2003) High dose chemotherapy and autologous stem cell transplantation in patients with peripheral T-cell lymphoma not achieving complete response after induction chemotherapy. The GEL–TAMO experience. Haematologica 88:1372–1377PubMed

17.

Siu LL, Chan JK, Kwong YL (2002) Natural killer cell malignancies: clinicopathologic and molecular features. Histol Histopathol 17:539–554PubMed

18.

Cheung MM, Chan JK, Lau WH, Foo W, Chan PT, Ng CS, Ngan RK (1998) Primary non-Hodgkin’s lymphoma of the nose and nasopharynx: clinical features, tumor immunophenotype, and treatment outcome in 113 patients. J Clin Oncol 16:70–77PubMed

19.

Au WY, Lie AK, Liang R, Kwong YL, Yau CC, Cheung MM, Ngan KC, Lau WH, Wong KH, Yiu HY, Cheng HC, Au KH, Chan JK (2003) Autologous stem cell transplantation for nasal NK/T-cell lymphoma: a progress report on its value. Ann Oncol 14:1673–1676PubMedCrossRef

20.

Bang SM, Kim YK, Park YH, Sohn SK, Lee JJ, Cho EK, Ryoo BY, Chung IJ, Yoon SS, Kim HJ, Lee JH, Yoon HJ, Park S (2005) High-dose therapy and autologous stem cell transplantation in Korean patients with aggressive T/NK-cell lymphoma. Leuk Lymphoma 46:1599–1604PubMedCrossRef

21.

Corradini P, Tarella C, Zallio F, Dodero A, Zanni M, Valagussa P, Gianni AM, Rambaldi A, Barbui T, Cortelazzo S (2006) Long-term follow-up of patients with peripheral T-cell lymphomas treated up-front with high-dose chemotherapy followed by autologous stem cell transplantation. Leukemia 20:1533–1538PubMedCrossRef

22.

Gallamini A, Stelitano C, Calvi R, Bellei M, Mattei D, Vitolo U, Morabito F, Martelli M, Brusamolino E, Iannitto E, Zaja F, Cortelazzo S, Rigacci L, Devizzi L, Todeschini G, Santini G, Brugiatelli M, Federico M (2004) Peripheral T-cell lymphoma unspecified (PTCL-U): a new prognostic model from a retrospective multicentric clinical study. Blood 103:2474–2479PubMedCrossRef

23.

Jantunen E, Wiklund T, Juvonen E, Putkonen M, Lehtinen T, Kuittinen O, Franssila K, Soderstrom KO, Leppa S, Elonen E, Remes K, Nousiainen T (2004) Autologous stem cell transplantation in adult patients with peripheral T-cell lymphoma: a nation-wide survey. Bone Marrow Transplant 33:405–410PubMedCrossRef

24.

Deconinck E, Lamy T, Foussard C, Gaillard F, Delwail V, Colombat P, Casassus P, Lemevel A, Brion A, Milpied N (2000) Autologous stem cell transplantation for anaplastic large-cell lymphomas: results of a prospective trial. Br J Haematol 109:736–742PubMedCrossRef

25.

Gascoyne RD, Aoun P, Wu D, Chhanabhai M, Skinnider BF, Greiner TC, Morris SW, Connors JM, Vose JM, Viswanatha DS, Coldman A, Weisenburger DD (1999) Prognostic significance of anaplastic lymphoma kinase (ALK) protein expression in adults with anaplastic large cell lymphoma. Blood 93:3913–3921PubMed

26.

Falini B, Pileri S, Zinzani PL, Carbone A, Zagonel V, Wolf-Peeters C, Verhoef G, Menestrina F, Todeschini G, Paulli M, Lazzarino M, Giardini R, Aiello A, Foss HD, Araujo I, Fizzotti M, Pelicci PG, Flenghi L, Martelli MF, Santucci A (1999) ALK+ lymphoma: clinico-pathological findings and outcome. Blood 93:2697–2706PubMed

27.

Corradini P, Dodero A, Zallio F, Caracciolo D, Casini M, Bregni M, Narni F, Patriarca F, Boccadoro M, Benedetti F, Rambaldi A, Gianni AM, Tarella C (2004) Graft-versus-lymphoma effect in relapsed peripheral T-cell non-Hodgkin’s lymphomas after reduced-intensity conditioning followed by allogeneic transplantation of hematopoietic cells. J Clin Oncol 22:2172–2176PubMedCrossRef

28.

Wulf GG, Hasenkamp J, Jung W, Chapuy B, Truemper L, Glass B (2005) Reduced intensity conditioning and allogeneic stem cell transplantation after salvage therapy integrating alemtuzumab for patients with relapsed peripheral T-cell non-Hodgkin’s lymphoma. Bone Marrow Transplant 36:271–273PubMedCrossRef

29.

Tsimberidou AM, Giles F, Duvic M, Fayad L, Kurzrock R (2004) Phase II study of pentostatin in advanced T-cell lymphoid malignancies: update of an M.D. Anderson Cancer Center series. Cancer 100:342–349PubMedCrossRef

30.

Mercieca J, Matutes E, Dearden C, MacLennan K, Catovsky D (1994) The role of pentostatin in the treatment of T-cell malignancies: analysis of response rate in 145 patients according to disease subtype. J Clin Oncol 12:2588–2593PubMed

31.

Sallah S, Wan JY, Nguyen NP (2001) Treatment of refractory T-cell malignancies using gemcitabine. Br J Haematol 113:185–187PubMedCrossRef

32.

Zinzani PL, Magagnoli M, Bendandi M, Orcioni GF, Gherlinzoni F, Albertini P, Pileri SA, Tura S (1998) Therapy with gemcitabine in pretreated peripheral T-cell lymphoma patients. Ann Oncol 9:1351–1353PubMedCrossRef

33.

Enblad G, Hagberg H, Erlanson M, Lundin J, MacDonald AP, Repp R, Schetelig J, Seipelt G, Osterborg A (2004) A pilot study of alemtuzumab (anti-CD52 monoclonal antibody) therapy for patients with relapsed or chemotherapy–refractory peripheral T-cell lymphomas. Blood 103:2920–2924PubMedCrossRef

34.

Nasr R, El-Sabban ME, Karam JA, Dbaibo G, Kfoury Y, Arnulf B, Lepelletier Y, Bex F, de The H, Hermine O, Bazarbachi A (2005) Efficacy and mechanism of action of the proteasome inhibitor PS-341 in T-cell lymphomas and HTLV-I associated adult T-cell leukemia/lymphoma. Oncogene 24:419–430PubMedCrossRef

Titel: High-dose chemotherapy and autologous stem cell transplantation for peripheral T-cell lymphoma: complete response at transplant predicts survival
verfasst von: Min Kyoung Kim
Shin Kim
Sung Sook Lee
Sun Jin Sym
Dae Ho Lee
Seongsoo Jang
Chan Jeong Park
Hyun Sook Chi
Jooryung Huh
Cheolwon Suh
Publikationsdatum: 01.06.2007
Verlag: Springer-Verlag
Erschienen in: Annals of Hematology / Ausgabe 6/2007
Print ISSN: 0939-5555
Elektronische ISSN: 1432-0584
DOI: https://doi.org/10.1007/s00277-007-0254-1

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Positiver FIT: Die Ursache liegt nicht immer im Dickdarm

27.05.2024 Blut im Stuhl Nachrichten

Immunchemischer Stuhltest positiv, Koloskopie negativ – in solchen Fällen kann die Blutungsquelle auch weiter proximal sitzen. Ein Forschungsteam hat nachgesehen, wie häufig und in welchen Lokalisationen das der Fall ist.

GLP-1-Agonisten können Fortschreiten diabetischer Retinopathie begünstigen

24.05.2024 Diabetische Retinopathie Nachrichten

Möglicherweise hängt es von der Art der Diabetesmedikamente ab, wie hoch das Risiko der Betroffenen ist, dass sich sehkraftgefährdende Komplikationen verschlimmern.

Mehr Lebenszeit mit Abemaciclib bei fortgeschrittenem Brustkrebs?

24.05.2024 Mammakarzinom Nachrichten

In der MONARCHE-3-Studie lebten Frauen mit fortgeschrittenem Hormonrezeptor-positivem, HER2-negativem Brustkrebs länger, wenn sie zusätzlich zu einem nicht steroidalen Aromatasehemmer mit Abemaciclib behandelt wurden; allerdings verfehlte der numerische Zugewinn die statistische Signifikanz.

ADT zur Radiatio nach Prostatektomie: Wenn, dann wohl länger

24.05.2024 Prostatakarzinom Nachrichten

Welchen Nutzen es trägt, wenn die Strahlentherapie nach radikaler Prostatektomie um eine Androgendeprivation ergänzt wird, hat die RADICALS-HD-Studie untersucht. Nun liegen die Ergebnisse vor. Sie sprechen für länger dauernden Hormonentzug.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 6/2007

Spectrum of Von Willebrand disease and inherited platelet function disorders amongst Indian bleeders

Genetic relationship between Murcia Region (SE Spain) and other populations in the Iberian Peninsula and Mediterranean area with respect to HFE gene mutations distribution

Value of pretransplant screening for colonization of Pseudomonas aeruginosa in reduced-intensity umbilical cord blood transplantation for adult patients

Enhanced expression of the nuclear envelope LAP2 transcriptional repressors in normal and malignant activated lymphocytes

Incidence of the HFE gene mutations in a cohort of non-Spanish origin neonates in Madrid