Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Non-Hodgkin's Lymphoma

High-dose therapy with autologous stem cell transplantation in patients with peripheral T cell lymphomas

Abstract

Peripheral T cell lymphomas (PTCL) have a poorer prognosis after conventional treatment than do high-grade B cell lymphomas. The place for high-dose therapy (HDT) with autologous stem cell support in these patients is still not clear. Forty patients, 10 women and 30 men, median age 41.5 years (range 16–61) with PTCL were treated with HDT and autologous stem cell support at The Norwegian Radium Hospital, Oslo, Norway and The University Hospital, Uppsala, Sweden, between February 1990 and September 1999. The histologic subtypes were: PTCL unspecified, 20 patients; intestinal, two patients; angioimmunoblastic (AILD), two patients; angiocentric, two patients and anaplastic large cell lymphoma (ALCL), 14 patients. All patients had chemosensitive disease and had received anthracycline-containing regimens prior to transplantation. At the time of HDT, 17 patients were in first PR or CR and 23 were in second or third PR or CR. Conditioning regimens were BEAM in 15 patients, BEAC in 14 patients, cyclophosphamide and total body irradiation (TBI) in eight patients, BEAC, without etoposide and TBI in one patient and mitoxantrone and melphalan in two patients. There were three (7.5%) treatment-related deaths. The estimated overall survival (OS) at 3 years was 58%, the event-free survival (EFS) 48% and the relapse-free survival (RFS) 56%, with a median follow-up of 36 months (range 7–100) for surviving patients. The patients with ALCL tended to have a better prognosis compared to those with other PTCL subtypes, OS 79% vs 44%, respectively. In conclusion, patients with chemosensitive PTCL who are failing to achieve CR with first-line chemotherapy or are in relapse can successfully be treated with HDT and autologous stem cell support. Bone Marrow Transplantation (2001) 27, 711–716.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Gisselbrecht C, Gaulard P, Lepage E et al. Prognostic significance of T-cell phenotype in aggressive non-Hodgkin's lymphomas. Groupe d'Etudes des Lymphomes de l'Adulte (GELA) Blood 1998 92: 76–82

    CAS  PubMed  Google Scholar 

  2. Melnyk A, Rodriguez A, Pugh WC et al. Evaluation of the Revised European–American Lymphoma classification confirms the clinical relevance of immunophenotype in 560 cases of aggressive non-Hodgkin's lymphoma Blood 1997 89: 4514–4520

    CAS  PubMed  Google Scholar 

  3. Armitage JO, Greer JP, Levine AM et al. Peripheral T-cell lymphoma Cancer 1989 63: 158–163

    Article  CAS  PubMed  Google Scholar 

  4. Coiffier B, Brousse N, Peuchmaur M et al. Peripheral T-cell lymphomas have a worse prognosis than B-cell lymphomas: a prospective study of 361 immunophenotyped patients treated with the LNH-84 regimen. The GELA (Groupe d'Etude des Lymphomes Agressives) Ann Oncol 1990 1: 45–50

    Article  CAS  PubMed  Google Scholar 

  5. Lippman SM, Miller TP, Spier CM et al. The prognostic significance of the immunotype in diffuse large-cell lymphoma: a comparative study of the T-cell and B-cell phenotype Blood 1988 72: 436–441

    CAS  PubMed  Google Scholar 

  6. Siegert W, Agthe A, Griesser H et al. Treatment of angioimmunoblastic lymphadenopathy (AILD)-type T-cell lymphoma using prednisone with or without the COPBLAM/IMVP-16 regimen. A multicenter study. Kiel Lymphoma Study Group Ann Intern Med 1992 117: 364–370

    Article  CAS  PubMed  Google Scholar 

  7. Siegert W, Nerl C, Engelhard M et al. Peripheral T-cell non-Hodgkin's lymphomas of low malignancy: prospective study of 25 patients with pleomorphic small cell lymphoma, lymphoepitheloid cell (Lennert's) lymphoma and T-zone lymphoma. The Kiel Lymphoma Study Group Br J Haematol 1994 87: 529–534

    Article  CAS  PubMed  Google Scholar 

  8. Zaja F, Russo D, Silvestri F et al. Retrospective analysis of 23 cases with peripheral T-cell lymphoma, unspecified: clinical characteristics and outcome Haematologica 1997 82: 171–177

    CAS  PubMed  Google Scholar 

  9. Armitage JO, Weisenburger DD . New approach to classifying non-Hodgkin's lymphomas: clinical features of the major histologic subtypes. Non-Hodgkin's Lymphoma Classification Project J Clin Oncol 1998 16: 2780–2795

    Article  CAS  PubMed  Google Scholar 

  10. Harris NL, Jaffe ES, Stein H et al. A revised European–American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group (see comments) Blood 1994 84: 1361–1392

    CAS  PubMed  Google Scholar 

  11. Jaffe ES, Krenacs L, Raffeld M . Classification of T-cell and NK-cell neoplasms based on the REAL classification Ann Oncol 1997 8: (Suppl. 2) 17–24

    Article  PubMed  Google Scholar 

  12. Gordon BG, Weisenburger DD, Sanger WG et al. Peripheral T-cell lymphoma in children and adolescents: role of bone marrow transplantation Leuk Lymphoma 1994 14: 1–10

    Article  CAS  PubMed  Google Scholar 

  13. Vose JM, Peterson C, Bierman PJ et al. Comparison of high-dose therapy and autologous bone marrow transplantation for T-cell and B-cell non-Hodgkin's lymphomas Blood 1990 76: 424–431

    CAS  PubMed  Google Scholar 

  14. Fanin R, Ruiz-de EM, Sperotto A et al. Autologous stem cell transplantation for T and null cell CD30-positive anaplastic large cell lymphoma: analysis of 64 adult and paediatric cases reported to the European Group for Blood and Marrow Transplantation (EBMT) Bone Marrow Transplant 1999 23: 437–442

    Article  CAS  PubMed  Google Scholar 

  15. Carbone PP, Kaplan HS, Musshoff K et al. Report of the Committee on Hodgkin's Disease Staging Classification Cancer Res 1971 31: 1860–1861

    CAS  PubMed  Google Scholar 

  16. Shipp MA . A predictive model for aggressive non-Hodgkin's lymphoma. The International Non-Hodgkin's Lymphoma Prognostic Factors Project (see comments) New Engl J Med 1993 329: 987–994

    Article  Google Scholar 

  17. Gianni AM, Bregni M, Siena S et al. High-dose chemotherapy and autologous bone marrow transplantation compared with MACOP-B in aggressive B-cell lymphoma (see comments) New Engl J Med 1997 336: 1290–1297

    Article  CAS  PubMed  Google Scholar 

  18. Reiter A, Schrappe M, Parwaresch R et al. Non-Hodgkin's lymphomas of childhood and adolescence: results of a treatment stratified for biologic subtypes and stage – a report of the Berlin–Frankfurt–Munster Group J Clin Oncol 1995 13: 359–372

    Article  CAS  PubMed  Google Scholar 

  19. DeAngelis LM, Yahalom J, Thaler HT et al. Combined modality therapy for primary CNS lymphoma J Clin Oncol 1992 10: 635–643

    Article  CAS  PubMed  Google Scholar 

  20. Berenson RJ, Bensinger WI, Hill RS et al. Engraftment after infusion of CD34+ marrow cells in patients with breast cancer or neuroblastoma Blood 1991 77: 1717–1722

    CAS  PubMed  Google Scholar 

  21. Kvalheim G, Wang MY, Pharo A et al. Purging of tumor cells from leukapheresis products: experimental and clinical aspects J Hematother 1996 5: 427–436

    Article  CAS  PubMed  Google Scholar 

  22. Wang MY, Kvalheim G, Kvaloy S et al. An effective immunomagnetic method for bone marrow purging in T cell malignancies Bone Marrow Transplant 1992 9: 319–323

    CAS  PubMed  Google Scholar 

  23. Haider K, Zamkoff KW, Gentile TC . High dose chemotherapy (HDCT) and autologous stem cell transplant (ASCT) in peripheral T-cell lymphoma (PTCL). A single institution experience Blood 1999 94: (Suppl. 1) 173a (Abstr.)

    Google Scholar 

  24. Rodriguez J, Khouri I, Palmer L et al. Salvage therapy with hematopoietic cell transplantation (HCT) in peripheral T-cell lymphomas (PTCL) Blood 1999 94: (Suppl. 1) 172a (Abstr.)

    Google Scholar 

  25. Fanin R, Silvestri F, Geromin A et al. Primary systemic CD30 (Ki-1)-positive anaplastic large cell lymphoma of the adult: sequential intensive treatment with the F-MACHOP regimen (+/− radiotherapy) and autologous bone marrow transplantation Blood 1996 87: 1243–1248

    CAS  PubMed  Google Scholar 

  26. Kingreen D, Reichle A, Fetscher S et al. High-dose chemotherapy (HDCT) with autologous stem cell transplantation (PBSCT) in patients with angioimmunoblastic T-cell lymphoma (AILD) Blood 1999 94: 172a (Abstr.)

    Google Scholar 

  27. Philip T, Guglielmi C, Hagenbeek A et al. Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non-Hodgkin's lymphoma (see comments) New Engl J Med 1995 333: 1540–1545

    Article  CAS  PubMed  Google Scholar 

  28. Lopez GA, Cid J, Salar A et al. 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 1998 9: 849–855

    Article  PubMed  Google Scholar 

  29. Tilly H, Gaulard P, Lepage E et al. Primary anaplastic large-cell lymphoma in adults: clinical presentation, immunophenotype, and outcome Blood 1997 90: 3727–3734

    CAS  PubMed  Google Scholar 

  30. Filippa DA, Ladanyi M, Wollner N et al. CD30 (Ki-1)-positive malignant lymphomas: clinical, immunophenotypic, histologic, and genetic characteristics and differences with Hodgkin's disease Blood 1996 87: 2905–2917

    CAS  PubMed  Google Scholar 

  31. Longo G, Federico M, Pieresca C et al. Anaplastic large cell lymphoma (CD30+/Ki-1+). Analysis of 35 cases followed at GISL centres Eur J Cancer 1995 31A: 1763–1767

    Article  CAS  PubMed  Google Scholar 

  32. Clavio M, Rossi E, Truini M et al. Anaplastic large cell lymphoma: a clinicopathologic study of 53 patients Leuk Lymphoma 1996 22: 319–327

    Article  CAS  PubMed  Google Scholar 

  33. Greer JP, Kinney MC, Collins RD et al. Clinical features of 31 patients with Ki-1 anaplastic large-cell lymphoma (see comments) J Clin Oncol 1991 9: 539–547

    Article  CAS  PubMed  Google Scholar 

  34. Shulman LN, Frisard B, Antin JH et al. Primary Ki-1 anaplastic large-cell lymphoma in adults: clinical characteristics and therapeutic outcome J Clin Oncol 1993 11: 937–942

    Article  CAS  PubMed  Google Scholar 

  35. Fanin R, Sperotto A, Silvestri F et al. The therapy of primary adult systemic CD30-positive anaplastic large cell lymphoma: results of 40 cases treated in a single center Leuk Lymphoma 1999 35: 159–169

    Article  CAS  PubMed  Google Scholar 

  36. Ansell SM, Habermann TM, Kurtin PJ et al. Predictive capacity of the International Prognostic Factor Index in patients with peripheral T-cell lymphoma J Clin Oncol 1997 15: 2296–2301

    Article  CAS  PubMed  Google Scholar 

  37. d'Amore F, Johansen P, Houmand A et al. Epstein–Barr virus genome in non-Hodgkin's lymphomas occurring in immunocompetent patients: highest prevalence in nonlymphoblastic T-cell lymphoma and correlation with a poor prognosis. Danish Lymphoma Study Group, LYFO Blood 1996 87: 1045–1055

    CAS  PubMed  Google Scholar 

  38. Blystad A, Kvalheim G, Torlakovic E et al. High-dose therapy supported with immunomagnetic purged autologous bone marrow in high-grade B cell non-Hodgkin's lymphoma Bone Marrow Transplant 1999 24: 865–872

    Article  CAS  PubMed  Google Scholar 

  39. Gribben JG, Freedman AS, Neuberg D et al. Immunologic purging of marrow assessed by PCR before autologous bone marrow transplantation for B-cell lymphoma (see comments) New Engl J Med 1991 325: 1525–1533

    Article  CAS  PubMed  Google Scholar 

  40. Schouten HC, Kvaloy S, Sydes M et al. The CUP trial: a randomized study analyzing the efficacy of high dose therapy and purging in low-grade non-Hodgkin's lymphoma (NHL) Ann Oncol 2000 11: 91–94

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors give special thanks to Eva Skovlund for statistical advice. This study was supported by The Norwegian Cancer Society and The Swedish Cancer Society.

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Blystad, A., Enblad, G., Kvaløy, S. et al. High-dose therapy with autologous stem cell transplantation in patients with peripheral T cell lymphomas. Bone Marrow Transplant 27, 711–716 (2001). https://doi.org/10.1038/sj.bmt.1702867

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1702867

Keywords

This article is cited by

Search

Quick links