Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2009, 153(1):63-66 | DOI: 10.5507/bp.2009.011

PROLONGED SURVIVAL OF PATIENTS WITH PERIPHERAL T-CELL LYMPHOMA AFTER FIRST-LINE INTENSIVE SEQUENTIAL CHEMOTHERAPY WITH AUTOLOGOUS STEM CELL TRANSPLANTATION

Vit Prochazkaa, Edgar Fabera, Ludek Raidaa, Jana Vondrakovaa, Ladislava Kucerovab, Marie Jarosovaa, Karel Indraka, Tomas Papajika
a Department of Hemato-Oncology, University Hospital, Olomouc, Czech Republic
b Department of Pathology, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic

BACKGROUND: Nodal peripheral T-cell lymphomas (PTCLs) are infrequent subtypes of non-Hodgkin's lymphomas. The WHO classification recognizes three subgroups of nodal PTCL: peripheral T-cell lymphoma not otherwise specified (PTCL, NOS), anaplastic large cell lymphoma (ALCL) and angioimmunoblastic lymphoma (AIL). The clinical course is aggressive and despite multiagent chemotherapy, the median survival is about 2 years. Optimal first-line chemotherapy is not established and the role of high-dose therapy with autologous stem cell support is still controversial.

AIM: To analyze the long-term outcome of PTCL patients treated with intensive first-line chemotherapy with highdose therapy and autologous transplant consolidation.

METHOD: Sequential chemotherapy protocol consisting of 3 cycles of CHOEP-21-like regimen (PACEBO), 1 cycle of an ifosfamide and methotrexate-based regimen (IVAM) and a priming regimen with high-dose cytosine arabinoside (HAM). Consolidation was provided with myeloablative conditioning (BEAM 200) and autologous stem cell support. Eighty-four patients with aggressive high-risk lymphoma were treated with the sequential protocol from 2000 to 2007 in our institution. Here we report our experience with 18 patients with nodal PTCL (10 PTCL, NOS; 3 ALCL, ALKnegative; 2 ALCL, ALK-positive; 2 ALCL, unknown ALK status; 1 AIL).

RESULTS: Eleven (61 %) patients achieved complete remission, 3 (17 %) partial remission and 4 (22 %) patients failed the procedure. The overall response rate was 77.8 %. After a median follow-up of 25.7 months, nine patients relapsed or progressed (6 PTCL, NOS; 2 ALCL ALK-positive; 1 ALCL ALK-negative; median 14.1 months) and four patients died (lymphoma progression). The relapse was treated with allogeneic stem transplantation in one patient. The 2-year progression-free survival (PFS) was 52 % (95 % CI, 0.27 to 0.76); the 2-year overall survival rate reached 71 % (95 % CI, 0.47 to 0.95).

CONCLUSION: Our results show that intensive first-line chemotherapy with high-dose therapy and autologous transplant consolidation offers a chance for long-term survival in patients with chemosensitive PTCL.

Keywords: Peripheral T-cell lymphoma, PTCL, High-dose chemotherapy, Autologous transplantation, First line

Received: April 30, 2008; Accepted: June 30, 2008; Published: March 1, 2009  Show citation

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Prochazka, V., Faber, E., Raida, L., Vondrakova, J., Kucerova, L., Jarosova, M., Indrak, K., & Papajik, T. (2009). PROLONGED SURVIVAL OF PATIENTS WITH PERIPHERAL T-CELL LYMPHOMA AFTER FIRST-LINE INTENSIVE SEQUENTIAL CHEMOTHERAPY WITH AUTOLOGOUS STEM CELL TRANSPLANTATION. Biomedical papers, 153(1), 63-66. doi: 10.5507/bp.2009.011
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