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.
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References
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
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
Armitage JO, Greer JP, Levine AM et al. Peripheral T-cell lymphoma Cancer 1989 63: 158–163
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
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
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
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
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
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
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
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
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
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
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
Carbone PP, Kaplan HS, Musshoff K et al. Report of the Committee on Hodgkin's Disease Staging Classification Cancer Res 1971 31: 1860–1861
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
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
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
DeAngelis LM, Yahalom J, Thaler HT et al. Combined modality therapy for primary CNS lymphoma J Clin Oncol 1992 10: 635–643
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
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
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
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.)
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.)
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
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.)
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
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
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
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
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
Clavio M, Rossi E, Truini M et al. Anaplastic large cell lymphoma: a clinicopathologic study of 53 patients Leuk Lymphoma 1996 22: 319–327
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
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
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
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
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
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
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
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
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.
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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
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DOI: https://doi.org/10.1038/sj.bmt.1702867
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