Up-Front Autologous Stem-Cell Transplantation in Peripheral T-Cell Lymphoma: NLG-T-01

被引：536

作者：

d'Amore, Francesco ^{[1
]}

Relander, Thomas ^{[4
]}

Lauritzsen, Grete F. ^{[9
]}

Jantunen, Esa ^{[12
]}

Hagberg, Hans ^{[6
]}

Anderson, Harald ^{[5
]}

Holte, Harald ^{[9
]}

Osterborg, Anders ^{[7
]}

Merup, Mats ^{[7
]}

Brown, Peter ^{[2
]}

Kuittinen, Outi ^{[13
]}

Erlanson, Martin ^{[8
]}

Ostenstad, Bjorn ^{[10
]}

Fagerli, Unn-Merete ^{[11
]}

Gadeberg, Ole V. ^{[3
]}

Sundstrom, Christer ^{[6
]}

Delabie, Jan ^{[9
]}

Ralfkiaer, Elisabeth ^{[2
]}

Vornanen, Martine ^{[14
]}

Toldbod, Helle E.

机构：

[1] Aarhus Univ Hosp, Dept Hematol, DK-8000 Aarhus C, Denmark

[2] Copenhagen Univ Hosp, Copenhagen, Denmark

[3] Vejle Hosp, Vejle, Denmark

[4] Skane Univ Hosp, Lund, Sweden

[5] Lund Univ, Lund, Sweden

[6] Univ Uppsala Hosp, Uppsala, Sweden

[7] Karolinska Univ Hosp, Stockholm, Sweden

[8] Umea Univ Hosp, S-90185 Umea, Sweden

[9] Oslo Univ Hosp, Radium Hosp, Oslo, Norway

[10] Ullevaal Univ Hosp, Oslo, Norway

[11] St Olavs Univ Hosp, Trondheim, Norway

[12] Kuopio Univ Hosp, SF-70210 Kuopio, Finland

[13] Oulu Univ Hosp, Oulu, Finland

[14] Tampere Univ Hosp, Tampere, Finland

来源：

JOURNAL OF CLINICAL ONCOLOGY | 2012年 / 30卷 / 25期

关键词：

NON-HODGKINS-LYMPHOMA; CHEMOTHERAPY; PROGNOSIS; CHOP; IMMUNOPHENOTYPE; THERAPY; TRIAL;

D O I：

10.1200/JCO.2011.40.2719

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 [肿瘤学];

摘要：

Purpose Systemic peripheral T-cell lymphomas (PTCLs) respond poorly to conventional therapy. To evaluate the efficacy of a dose-dense approach consolidated by up-front high-dose chemotherapy (HDT) and autologous stem-cell transplantation (ASCT) in PTCL, the Nordic Lymphoma Group (NLG) conducted a large prospective phase II study in untreated systemic PTCL. This is the final report, with a 5-year median follow-up, of the NLG-T-01 study. Patients and Methods Treatment-naive patients with PTCL age 18 to 67 years (median, 57 years) were included. Anaplastic lymphoma kinase (ALK) -positive anaplastic large-cell lymphoma (ALCL) was excluded. An induction regimen of six cycles of biweekly CHOEP (cyclophosphamide, doxorubicin, vincristine, etoposide, and prednisone) was administered (in patients age > 60 years, etoposide was omitted). If in complete or partial remission, patients proceeded to consolidation with HDT/ASCT. Results Of 166 enrolled patients, 160 had histopathologically confirmed PTCL. The majority presented with advanced-stage disease, B symptoms, and elevated serum lactate dehydrogenase. A total of 115 underwent HDT/ASCT, with 90 in complete remission at 3 months post-transplantation. Early failures occurred in 26%. Treatment-related mortality was 4%. At 60.5 months of median follow-up, 83 patients were alive. Consolidated 5-year overall and progression-free survival (PFS) were 51% (95% CI, 43% to 59%) and 44% (95% CI, 36% to 52%), respectively. Best results were obtained in ALK-negative ALCL. Conclusion Dose-dense induction followed by HDT/ASCT was well tolerated and led to long-term PFS in 44% of treatment-naive patients with PTCL. This represents an encouraging outcome, particularly considering the high median age and adverse risk profile of the study population. Therefore, dose-dense induction and HDT/ASCT are a rational up-front strategy in transplantation-eligible patients with PTCL. J Clin Oncol 30: 3093-3099. (C) 2012 by American Society of Clinical Oncology

引用

页码：3093 / 3099

页数：7

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