Long-term disease-free survival in patients with angioimmunoblastic T-cell lymphoma after high-dose chemotherapy and autologous stem cell transplantation

• Published in: Haematologica (Roma) Vol. 88; no. 11; pp. 1272 - 1278
• Main Authors: Schetelig, J, Fetscher, S, Reichle, A, Berdel, WE, Beguin, Y, Brunet, S, Caballero, D, Majolino, I, Hagberg, H, Johnsen, HE, Kimby, E, Montserrat, E, Stewart, D, Copplestone, A, Rosler, W, Pavel, J, Kingreen, D, Siegert, W
• Format: Journal Article Web Resource
• Language: English
• Published: Pavia Haematologica 01-11-2003; Ferrata Storti Foundation
• Subjects: Adult; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Combined Modality Therapy; Disease Progression; Disease-Free Survival; Female; Health Surveys; Hematologic and hematopoietic diseases; Hematology; Human health sciences; Humans; Hématologie; Immunoblastic Lymphadenopathy - drug therapy; Immunoblastic Lymphadenopathy - mortality; Immunoblastic Lymphadenopathy - therapy; Immunoblastic Lymphadenopathy/drug therapy/mortality/therapy; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Life Tables; Lymphoma, T-Cell - drug therapy; Lymphoma, T-Cell - mortality; Lymphoma, T-Cell - therapy; Lymphoma, T-Cell/drug therapy/mortality/therapy; Male; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Peripheral Blood Stem Cell Transplantation; Remission Induction; Retrospective Studies; Salvage Therapy; Sciences de la santé humaine; Survival Analysis; Transplantation Conditioning; Transplantation, Autologous; Treatment Outcome; Antineoplastic agent; Human; Prognosis; Stem cell; autologous stem cell transplantation; Hematopoietic cell; angioimmunoblastic T-cell lymphoma; Malignant hemopathy; Non Hodgkin lymphoma; Long term; Survival; Peripheral T cell lymphoma; Autograft; Chemotherapy; Treatment; Lymphoproliferative syndrome; Bone marrow; Graft; High dose; high-dose chemotherapy
• ISSN: 0390-6078; 1592-8721; 1592-8721

Klinik fur Innere Medizin m. S. Hamatologie und Onkologie, Humboldt Universitat, Germany.
BACKGROUND AND OBJECTIVES: Patients with angioimmunoblastic T-cell lymphoma (AIL) have a poor prognosis with conventional treatment. DESIGN AND METHODS: We initiated an EBMT-based survey studying the impact of high-dose chemotherapy (HDCT) and autologous hematopoietic stem cell transplantation in patients with AIL. Data on 29 patients, who were transplanted between 1992 and 1998 in 16 transplant centers, were collected on standardized documentation forms. RESULTS: The median age at transplantation was 53 years. HDCT was given as part of 1st-line therapy (N=14; 48%) or 2nd/3rd-line therapy (N=15; 52%). Regimens for the mobilization of peripheral blood stem cells (PBSC) included VIPE (N=7; 26%), DexaBEAM (N=6; 22%), CHOP-like regimens (N=6; 22%), other regimens (N=5; 19%) or alternatively growth factor alone (N=3; 11%). The median yield of PBSC was 3.8x106 CD34+cells/kg. Two patients received autologous bone marrow. The HDCT consisted of BEAM-type regimens in 16 patients, ICE-type regimens in 7, and other regimens in 6 patients. There was one treatment-related death. The rate of complete remissions increased from 45% before HDCT to 76% after HDCT. As of January 2003, after a median observation time of living patients of 5 years (range 2.5 to 10 years), 14 patients have died (13 from progressive disease), and 15 patients are alive. The probability of 5-year overall and event-free survival was 44% (95% CI, 22% to 66%) and 37% (95% CI, 17% to 57%), respectively. Long-term disease-free survival was observed in patients transplanted during 1st-line treatment as well as in the context of 2nd/3rd-line therapy. INTERPRETATION AND CONCLUSIONS: There is evidence that AIL is susceptible to high-dose chemotherapy. HDCT and autologous stem cell transplantation should be considered in selected patients with AIL.