A retrospective analysis of peripheral T-cell lymphoma treated with the intention to transplant in the first remission

Neha Mehta, Jocelyn C. Maragulia, Allison Moskowitz, Paul A. Hamlin, Matthew A Lunning, Craig H. Moskowitz, Andrew Zelenetz, Matthew J. Matasar, Craig Sauter, Jenna Goldberg, Steven M. Horwitz

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background Peripheral T-cell lymphomas are aggressive lymphomas that have no standard treatment. Studies suggest that HD-ASCT in the first CR improves outcome. Few data exist regarding allo-HSCT in the first CR. Patients and Methods We retrospectively identified patients (2001-2011) with PTCL-not otherwise specified, angioimmunoblastic T-cell lymphoma, and anaplastic lymphoma kinase-negative anaplastic large cell lymphoma, initially treated with CHOP, CHOP-ICE (ifosfamide, carboplatin, etoposide), or other therapy with the intention to transplant in the first CR. Disease characteristics, therapy, progression-free survival (PFS), and OS were evaluated. Results Sixty-five patients were identified. PFS and OS were 38% and 52%, respectively, at 4 years. CHOP and CHOP-ICE regimens had similar outcomes. Treatment with allo-HSCT and HD-ASCT had OS at 4 years of 66% and 67%, respectively. Patients who did not proceed to transplant had OS of 27%. IPI score ≤ 2 and Prognostic Index for T-cell Lymphomas scores ≤ 1 predicted improved outcome. Combined analysis of interim response to CHOP and IPI score also predicted PFS and OS. Conclusion Our results support consolidation of first CR with transplantation. The addition of etoposide did not improve outcomes. Baseline IPI and interim response to CHOP can predict outcomes and guide decisions about transplantation in first CR in PTCL. Randomized trials are necessary to confirm the efficacy of this approach.

Original languageEnglish (US)
Pages (from-to)664-670
Number of pages7
JournalClinical Lymphoma, Myeloma and Leukemia
Volume13
Issue number6
DOIs
StatePublished - Dec 1 2013

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Peripheral T-Cell Lymphoma
Disease-Free Survival
Transplants
T-Cell Lymphoma
Etoposide
Transplantation
Anaplastic Large-Cell Lymphoma
Ifosfamide
Carboplatin
Therapeutics
Lymphoma

Keywords

  • Allogeneic
  • Autologous
  • Non-hodgkin's lymphoma
  • PTCL
  • Transplantation

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

A retrospective analysis of peripheral T-cell lymphoma treated with the intention to transplant in the first remission. / Mehta, Neha; Maragulia, Jocelyn C.; Moskowitz, Allison; Hamlin, Paul A.; Lunning, Matthew A; Moskowitz, Craig H.; Zelenetz, Andrew; Matasar, Matthew J.; Sauter, Craig; Goldberg, Jenna; Horwitz, Steven M.

In: Clinical Lymphoma, Myeloma and Leukemia, Vol. 13, No. 6, 01.12.2013, p. 664-670.

Research output: Contribution to journalArticle

Mehta, N, Maragulia, JC, Moskowitz, A, Hamlin, PA, Lunning, MA, Moskowitz, CH, Zelenetz, A, Matasar, MJ, Sauter, C, Goldberg, J & Horwitz, SM 2013, 'A retrospective analysis of peripheral T-cell lymphoma treated with the intention to transplant in the first remission', Clinical Lymphoma, Myeloma and Leukemia, vol. 13, no. 6, pp. 664-670. https://doi.org/10.1016/j.clml.2013.07.005
Mehta, Neha ; Maragulia, Jocelyn C. ; Moskowitz, Allison ; Hamlin, Paul A. ; Lunning, Matthew A ; Moskowitz, Craig H. ; Zelenetz, Andrew ; Matasar, Matthew J. ; Sauter, Craig ; Goldberg, Jenna ; Horwitz, Steven M. / A retrospective analysis of peripheral T-cell lymphoma treated with the intention to transplant in the first remission. In: Clinical Lymphoma, Myeloma and Leukemia. 2013 ; Vol. 13, No. 6. pp. 664-670.
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abstract = "Background Peripheral T-cell lymphomas are aggressive lymphomas that have no standard treatment. Studies suggest that HD-ASCT in the first CR improves outcome. Few data exist regarding allo-HSCT in the first CR. Patients and Methods We retrospectively identified patients (2001-2011) with PTCL-not otherwise specified, angioimmunoblastic T-cell lymphoma, and anaplastic lymphoma kinase-negative anaplastic large cell lymphoma, initially treated with CHOP, CHOP-ICE (ifosfamide, carboplatin, etoposide), or other therapy with the intention to transplant in the first CR. Disease characteristics, therapy, progression-free survival (PFS), and OS were evaluated. Results Sixty-five patients were identified. PFS and OS were 38{\%} and 52{\%}, respectively, at 4 years. CHOP and CHOP-ICE regimens had similar outcomes. Treatment with allo-HSCT and HD-ASCT had OS at 4 years of 66{\%} and 67{\%}, respectively. Patients who did not proceed to transplant had OS of 27{\%}. IPI score ≤ 2 and Prognostic Index for T-cell Lymphomas scores ≤ 1 predicted improved outcome. Combined analysis of interim response to CHOP and IPI score also predicted PFS and OS. Conclusion Our results support consolidation of first CR with transplantation. The addition of etoposide did not improve outcomes. Baseline IPI and interim response to CHOP can predict outcomes and guide decisions about transplantation in first CR in PTCL. Randomized trials are necessary to confirm the efficacy of this approach.",
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AU - Mehta, Neha

AU - Maragulia, Jocelyn C.

AU - Moskowitz, Allison

AU - Hamlin, Paul A.

AU - Lunning, Matthew A

AU - Moskowitz, Craig H.

AU - Zelenetz, Andrew

AU - Matasar, Matthew J.

AU - Sauter, Craig

AU - Goldberg, Jenna

AU - Horwitz, Steven M.

PY - 2013/12/1

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N2 - Background Peripheral T-cell lymphomas are aggressive lymphomas that have no standard treatment. Studies suggest that HD-ASCT in the first CR improves outcome. Few data exist regarding allo-HSCT in the first CR. Patients and Methods We retrospectively identified patients (2001-2011) with PTCL-not otherwise specified, angioimmunoblastic T-cell lymphoma, and anaplastic lymphoma kinase-negative anaplastic large cell lymphoma, initially treated with CHOP, CHOP-ICE (ifosfamide, carboplatin, etoposide), or other therapy with the intention to transplant in the first CR. Disease characteristics, therapy, progression-free survival (PFS), and OS were evaluated. Results Sixty-five patients were identified. PFS and OS were 38% and 52%, respectively, at 4 years. CHOP and CHOP-ICE regimens had similar outcomes. Treatment with allo-HSCT and HD-ASCT had OS at 4 years of 66% and 67%, respectively. Patients who did not proceed to transplant had OS of 27%. IPI score ≤ 2 and Prognostic Index for T-cell Lymphomas scores ≤ 1 predicted improved outcome. Combined analysis of interim response to CHOP and IPI score also predicted PFS and OS. Conclusion Our results support consolidation of first CR with transplantation. The addition of etoposide did not improve outcomes. Baseline IPI and interim response to CHOP can predict outcomes and guide decisions about transplantation in first CR in PTCL. Randomized trials are necessary to confirm the efficacy of this approach.

AB - Background Peripheral T-cell lymphomas are aggressive lymphomas that have no standard treatment. Studies suggest that HD-ASCT in the first CR improves outcome. Few data exist regarding allo-HSCT in the first CR. Patients and Methods We retrospectively identified patients (2001-2011) with PTCL-not otherwise specified, angioimmunoblastic T-cell lymphoma, and anaplastic lymphoma kinase-negative anaplastic large cell lymphoma, initially treated with CHOP, CHOP-ICE (ifosfamide, carboplatin, etoposide), or other therapy with the intention to transplant in the first CR. Disease characteristics, therapy, progression-free survival (PFS), and OS were evaluated. Results Sixty-five patients were identified. PFS and OS were 38% and 52%, respectively, at 4 years. CHOP and CHOP-ICE regimens had similar outcomes. Treatment with allo-HSCT and HD-ASCT had OS at 4 years of 66% and 67%, respectively. Patients who did not proceed to transplant had OS of 27%. IPI score ≤ 2 and Prognostic Index for T-cell Lymphomas scores ≤ 1 predicted improved outcome. Combined analysis of interim response to CHOP and IPI score also predicted PFS and OS. Conclusion Our results support consolidation of first CR with transplantation. The addition of etoposide did not improve outcomes. Baseline IPI and interim response to CHOP can predict outcomes and guide decisions about transplantation in first CR in PTCL. Randomized trials are necessary to confirm the efficacy of this approach.

KW - Allogeneic

KW - Autologous

KW - Non-hodgkin's lymphoma

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KW - Transplantation

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