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Multicenter Study
. 2022 Nov 1;107(11):2675-2684.
doi: 10.3324/haematol.2021.279426.

Autologous stem-cell transplantation as consolidation of first-line chemotherapy in patients with peripheral T-cell lymphoma: a multicenter GELTAMO/FIL study

Alejandro Martín García-Sancho  1 , Monica Bellei  2 , Miriam López-Parra  3 , Giuseppe Gritti  4 , María Cortés  5 , Silvana Novelli  6 , Carlos Panizo  7 , Luigi Petrucci  8 , Antonio Gutiérrez  9 , Ivan Dlouhy  10 , Mariana Bastos-Oreiro  11 , Juan M Sancho  12 , María J Ramírez  13 , José M Moraleda  14 , Estrella Carrillo  15 , Ana I Jiménez-Ubieto  16 , Isidro Jarque  17 , Lorella Orsucci  18 , Estefanía García-Torres  19 , Carlos Montalbán  20 , Anna Dodero  21 , Reyes Arranz  22 , Natalia De Las Heras  23 , María J Pascual  24 , Javier López-Jiménez  25 , Michelle Spina  26 , Alessandro Re  27 , Sonia González De Villambrosia  28 , Sabela Bobillo  29 , Massimo Federico  30 , Dolores Caballero  3
Affiliations
Multicenter Study

Autologous stem-cell transplantation as consolidation of first-line chemotherapy in patients with peripheral T-cell lymphoma: a multicenter GELTAMO/FIL study

Alejandro Martín García-Sancho et al. Haematologica. .

Abstract

Peripheral T-cell lymphomas (PTCL) are a heterogeneous group of rare lymphoid malignancies that mostly have poor prognoses with currently available treatments. Upfront consolidation with autologous stem cell transplantation (ASCT) is frequently carried out, but its efficacy has never been investigated in randomized trials. We designed a multicenter, international, retrospective study with the main objective of comparing progression-free survival and overall survival of patients with PTCL who underwent ASCT in complete remission (CR) after first-line chemotherapy with a control group who did not undergo ASCT. From the initial population of 286 registered patients, 174 patients with PTCL other than anaplastic large cell lymphoma, ALK-positive, deemed fit for ASCT at the time of diagnosis, and who were in CR or uncertain CR after induction therapy (CR1) were included in our analysis. one hundred and three patients underwent ASCT, whereas 71 did not, in most cases (n=53) because the physician decided against it. With a median follow-up of 65.5 months, progression-free survival was significantly better in the transplanted patients than in the non-transplanted group: 63% versus 48% at 5 years (P=0.042). Overall survival was significantly longer for ASCT patients in the subgroup with advanced stage at diagnosis (5-year overall survival: 70% vs. 50%, P=0.028). In the multivariate analysis, first-line ASCT was associated with significantly prolonged progression-free survival (HR=0.57, 95% CI: 0.35-0.93) and overall survival (HR=0.57, 95% CI: 0.33-0.99). In conclusion, our study supports the use of ASCT as a consolidation strategy for patients with PTCL in CR1. These results should be confirmed in a prospective randomized study.

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Figures

Figure 1.
Figure 1.
Study flowchart. *Relapse within 3 months of the initiation of the last cycle of first-line treatment. **Relapse beyond 3 months of the initiation of the last cycle of first-line treatment. ALCL: anaplastic large cell lymphoma; ASCT: autologous stem-cell transplantation; CR: complete remission; CRu: unconfirmed complete remission.
Figure 2.
Figure 2.
Kaplan�Meier estimation of survival in the transplanted and non-transplanted cohorts. (A) Progression-free survival; (B) overall survival. ASCT: autologous stem-cell transplantation
Figure 3.
Figure 3.
Kaplan-Meier estimation of overall survival by stage at diagnosis in the transplanted and non-transplanted cohorts. ASCT: autologous stem-cell transplantation.
See this image and copyright information in PMC

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References

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