Autologous stem cell transplantation in first complete remission may not extend progression-free survival in patients with peripheral T cell lymphomas

Clinton Yam, Daniel J. Landsburg, Kevin T. Nead, Xinyi Lin, Anthony R. Mato, Jakub Svoboda, Alison W. Loren, Noelle V. Frey, Edward A. Stadtmauer, David L. Porter, Stephen J. Schuster, Sunita D. Nasta

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

Patients with peripheral T cell lymphomas (PTCL) generally have a poor prognosis when treated with conventional chemotherapy. Consolidation with autologous stem cell transplantation (ASCT) has been reported to improve progression-free survival. However, these studies have not compared consolidative ASCT with active observation in patients with PTCL achieving first complete remission (CR1) following induction chemotherapy. We conducted a retrospective analysis of PTCL patients treated at the University of Pennsylvania between 1/1/2007 and 12/31/2014. Patients with cutaneous T cell lymphoma, concurrent B cell lymphomas, and anaplastic lymphoma kinase-positive anaplastic large cell lymphoma (ALK-positive ALCL) were excluded from the study. We compared progression-free survival for patients who underwent ASCT in CR1 following CHOP-like induction regimens and patients who underwent active observation during CR1. 48 patients met all inclusion and exclusion criteria and underwent either active observation (28 patients) or consolidative ASCT (20 patients) in CR1. The 1-year cumulative incidence of relapse in the observation and ASCT groups was 50% (95% confidence interval [CI]: 30–67%) and 46% (95% CI: 23–67%), respectively (P = 0.55). Median progression-free survival in the observation and ASCT groups was 15.8 and 12.8 months, respectively (log rank, P = 0.79). Estimated 3-year progression-free survival in the observation and ASCT groups was 37 and 41%, respectively. In conclusion, for PTCL patients achieving CR1 following CHOP-like induction chemotherapy, ASCT does not appear to improve progression-free survival compared to active observation. This finding should be confirmed in a larger, prospective study. Am. J. Hematol. 91:672–676, 2016.

Original languageEnglish (US)
Pages (from-to)672-676
Number of pages5
JournalAmerican journal of hematology
Volume91
Issue number7
DOIs
StatePublished - Jul 1 2016
Externally publishedYes

ASJC Scopus subject areas

  • Hematology

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