Autologous stem-cell transplantation as consolidation of first-line chemotherapy in patients with peripheral T-cell lymphoma: a multicenter GELTAMO/FIL study
Por:
Garcia-Sancho, AM, Bellei, M, Lopez-Parra, M, Gritti, G, Cortes, M, Novelli, S, Panizo, C, Petrucci, L, Gutierrez, A, Dlouhy, I, Bastos-Oreiro, M, Sancho, JM, Ramirez, MJ, Moraleda, JM, Carrillo, E, Jimenez-Ubieto, AI, Jarque, I, Orsucci, L, Garcia-Torres, E, Montalban, C, Dodero, A, Arranz, R, De las Heras, N, Pascual, MJ, Lopez-Jimenez, J, Spina, M, Re, A, De Villambrosia, SG, Bobillo, S, Federico, M and Caballero, D
Publicada:
1 nov 2022
Resumen:
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.
Filiaciones:
Garcia-Sancho, AM:
Hosp Univ Salamanca, Dept Hematol, CIBERONC, IBSAL, Salamanca, Spain
Bellei, M:
Fdn Italiana Linfomi FIL Onlus, Modena, Italy
Lopez-Parra, M:
Hosp Univ Salamanca, Dept Hematol, CIBERONC, IBSAL, Salamanca, Spain
Gritti, G:
ASST Papa Giovanni XXIII, Hematol & Bone Marrow Transplant Unit, Bergamo, Italy
Cortes, M:
Hosp Univ Salamanca, Dept Stat, IBSAL, Salamanca, Spain
Novelli, S:
Hosp Santa Creu & Sant Pau, Hematol Dept, Jose Carreras Leukemia Res Inst, Barcelona, Spain
IIB St Pau, Barcelona, Spain
Panizo, C:
CLin Univ Navarra, Dept Hematol, IdiSNA, Pamplona, Spain
Petrucci, L:
Sapienza Univ, Dept Translat & Precis Med, Rome, Italy
Gutierrez, A:
Son Espases Univ Hosp, Dept Hematol, IdISBa, Palma De Mallorca, Spain
Dlouhy, I:
Hosp Clin Barcelona, Dept Hematol, Barcelona, Spain
Bastos-Oreiro, M:
Hosp Gregorio Maranon, Hematol Dept, IISGM, Madrid, Spain
:
ICO IJC Hosp Germans Trias & Pujol, Hematol Dept, Badalona, Spain
Ramirez, MJ:
Hosp Especialidades Jerez Frontera, Hematol Dept, Cadiz, Spain
Moraleda, JM:
Hosp Clin Univ Virgen de la Arrixaca, Hematol Dept, Murcia, Spain
Carrillo, E:
Hosp Univ Virgen del Rocio, Hematol Dept, Seville, Spain
Jimenez-Ubieto, AI:
Hosp Univ 12 Octubre, Hematol Dept, Madrid, Spain
Jarque, I:
Hosp Univ & Politecn La Fe, Hematol Dept, CIBERONC, Inst Carlos III, Valencia, Spain
Orsucci, L:
Azienda Osped Univ Citta Delta Salute & Delta Sci, Hematol, Multidisciplinary Outpatient Oncol Clin, Candioto Canc Inst,FPO IRCCS, Turin, Italy
Garcia-Torres, E:
Hosp Univ Reina Sofia, Hematol Dept, Cordoba, Spain
Montalban, C:
MD Anderson Canc Ctr, Dept Translat Res, Madrid, Spain
Dodero, A:
Fdn IRCCS Ist Nazl Tumori, Div Hematol & Bone Marrow Transplantat, Milan, Italy
Arranz, R:
Hosp La Princesa, Hematol Dept, Madrid, Spain
De las Heras, N:
Complejo Hosp Leon, Dept Hematol, Leon, Spain
Pascual, MJ:
Reg Hosp, Hematol Dept, Malaga, Spain
Lopez-Jimenez, J:
Hosp Univ Ramon y Cajal, Hematol Dept, Madrid, Spain
Spina, M:
Ctr Riferimento Oncol Aviano CRO IRCCS, Div Med Oncol & Immune Related Tumors, Aviano, Italy
Re, A:
ASST Spedati Civili Brescia, Div Hematol, Brescia, Italy
De Villambrosia, SG:
Hosp Univ Marques de Valdecilla, Hematol Dept, Santander, Spain
Bobillo, S:
Univ Hosp Vall dHebron, Dept Hematol, Barcelona, Spain
Univ Autonoma Barcelona, Barcelona, Spain
Federico, M:
Univ Modena & Reggio Emilia, Med Oncol, CHIMOMO Dept, Modena, Italy
Caballero, D:
Hosp Univ Salamanca, Dept Hematol, CIBERONC, IBSAL, Salamanca, Spain
gold, Green Published
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