The role of autologous stem cell transplantation in patients with nodal peripheral T-cell lymphomas in first complete remission: Report from COMPLETE, a prospective, multicenter cohort study.
Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Cohort Studies
Female
Hematopoietic Stem Cell Transplantation
/ methods
Humans
Immunoblastic Lymphadenopathy
/ mortality
Lymphatic Metastasis
Lymphoma, T-Cell, Peripheral
/ mortality
Male
Middle Aged
Remission Induction
Retrospective Studies
Transplantation, Autologous
Young Adult
anaplastic lymphoma kinase (ALK)-negative anaplastic large cell lymphoma
angioimmunoblastic T-cell lymphoma (AITL)
autologous stem cell transplant
first complete remission
nodal peripheral T-cell lymphoma
peripheral T-cell lymphoma (PTCL) not otherwise specified (NOS)
Journal
Cancer
ISSN: 1097-0142
Titre abrégé: Cancer
Pays: United States
ID NLM: 0374236
Informations de publication
Date de publication:
01 05 2019
01 05 2019
Historique:
received:
29
06
2018
revised:
26
09
2018
accepted:
28
09
2018
pubmed:
30
1
2019
medline:
28
1
2020
entrez:
30
1
2019
Statut:
ppublish
Résumé
The role of autologous stem cell transplantation (ASCT) in the first complete remission (CR1) of peripheral T-cell lymphomas (PTCLs) is not well defined. This study analyzed the impact of ASCT on the clinical outcomes of patients with newly diagnosed PTCL in CR1. Patients with newly diagnosed, histologically confirmed, aggressive PTCL were prospectively enrolled into the Comprehensive Oncology Measures for Peripheral T-Cell Lymphoma Treatment (COMPLETE) study, and those in CR1 were included in this analysis. Two hundred thirteen patients with PTCL achieved CR1, and 119 patients with nodal PTCL, defined as anaplastic lymphoma kinase-negative anaplastic large cell lymphoma, angioimmunoblastic T-cell lymphoma (AITL), or PTCL not otherwise specified, were identified. Eighty-three patients did not undergo ASCT, whereas 36 underwent consolidative ASCT in CR1. At the median follow-up of 2.8 years, the median overall survival was not reached for the entire cohort of patients who underwent ASCT, whereas it was 57.6 months for those not receiving ASCT (P = .06). ASCT was associated with superior survival for patients with advanced-stage disease or intermediate-to-high International Prognostic Index scores. ASCT significantly improved overall and progression-free survival for patients with AITL but not for patients with other PTCL subtypes. In a multivariable analysis, ASCT was independently associated with improved survival (hazard ratio, 0.37; 95% confidence interval, 0.15-0.89). This is the first large prospective cohort study directly comparing the survival outcomes of patients with nodal PTCL in CR1 with or without consolidative ASCT. ASCT may provide a benefit in specific clinical scenarios, but the broader applicability of this strategy should be determined in prospective, randomized trials. These results provide a platform for designing future studies of previously untreated PTCL.
Sections du résumé
BACKGROUND
The role of autologous stem cell transplantation (ASCT) in the first complete remission (CR1) of peripheral T-cell lymphomas (PTCLs) is not well defined. This study analyzed the impact of ASCT on the clinical outcomes of patients with newly diagnosed PTCL in CR1.
METHODS
Patients with newly diagnosed, histologically confirmed, aggressive PTCL were prospectively enrolled into the Comprehensive Oncology Measures for Peripheral T-Cell Lymphoma Treatment (COMPLETE) study, and those in CR1 were included in this analysis.
RESULTS
Two hundred thirteen patients with PTCL achieved CR1, and 119 patients with nodal PTCL, defined as anaplastic lymphoma kinase-negative anaplastic large cell lymphoma, angioimmunoblastic T-cell lymphoma (AITL), or PTCL not otherwise specified, were identified. Eighty-three patients did not undergo ASCT, whereas 36 underwent consolidative ASCT in CR1. At the median follow-up of 2.8 years, the median overall survival was not reached for the entire cohort of patients who underwent ASCT, whereas it was 57.6 months for those not receiving ASCT (P = .06). ASCT was associated with superior survival for patients with advanced-stage disease or intermediate-to-high International Prognostic Index scores. ASCT significantly improved overall and progression-free survival for patients with AITL but not for patients with other PTCL subtypes. In a multivariable analysis, ASCT was independently associated with improved survival (hazard ratio, 0.37; 95% confidence interval, 0.15-0.89).
CONCLUSIONS
This is the first large prospective cohort study directly comparing the survival outcomes of patients with nodal PTCL in CR1 with or without consolidative ASCT. ASCT may provide a benefit in specific clinical scenarios, but the broader applicability of this strategy should be determined in prospective, randomized trials. These results provide a platform for designing future studies of previously untreated PTCL.
Identifiants
pubmed: 30694529
doi: 10.1002/cncr.31861
pmc: PMC8269282
mid: NIHMS1714793
doi:
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1507-1517Subventions
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Commentaires et corrections
Type : ErratumIn
Informations de copyright
© 2019 American Cancer Society.
Références
Cancer. 2017 Apr 1;123(7):1174-1183
pubmed: 27911989
Ann Oncol. 2014 Nov;25(11):2211-2217
pubmed: 25193992
Blood. 2008 Jun 15;111(12):5496-504
pubmed: 18385450
J Clin Oncol. 2009 Jan 1;27(1):106-13
pubmed: 19029417
N Engl J Med. 2013 Oct 31;369(18):1681-90
pubmed: 24171516
Blood. 2015 Jul 2;126(1):17-25
pubmed: 25869285
Bone Marrow Transplant. 2007 Sep;40(5):443-50
pubmed: 17589529
J Natl Compr Canc Netw. 2016 Sep;14(9):1067-79
pubmed: 27587620
J Clin Oncol. 2016 Mar 20;34(9):963-71
pubmed: 26962200
Leukemia. 2006 Sep;20(9):1533-8
pubmed: 16871285
J Clin Oncol. 2004 Jul 15;22(14):2826-34
pubmed: 15254050
Ann Oncol. 2004 Dec;15(12):1790-7
pubmed: 15550584
J Clin Oncol. 2007 Feb 10;25(5):579-86
pubmed: 17242396
Ann Oncol. 2004 Oct;15(10):1467-75
pubmed: 15367405
Hematol Oncol Clin North Am. 2008 Oct;22(5):997-1005, x
pubmed: 18954748
J Clin Oncol. 2012 Sep 1;30(25):3093-9
pubmed: 22851556
J Clin Oncol. 2013 Sep 1;31(25):3100-9
pubmed: 23897963
Haematologica. 2007 Aug;92(8):1067-74
pubmed: 17640855
Blood Rev. 2007 Jul;21(4):201-16
pubmed: 17512649
J Clin Oncol. 2008 Jan 10;26(2):218-24
pubmed: 18182664
Ann Oncol. 2008 May;19(5):958-63
pubmed: 18303032
Clin Lymphoma Myeloma Leuk. 2017 Apr;17(4):193-200
pubmed: 28209473
J Clin Oncol. 2017 Dec 20;35(36):4019-4026
pubmed: 29072976