PURPOSE: Patients with angioimmunoblastic T-cell lymphoma (AITL) have poor prognoses with current conventional chemotherapy. The aim of this study was to evaluate the effect of high-dose therapy (HDT) followed by autologous stem-cell transplantation (ASCT) on patients with AITL. PATIENTS AND METHODS: We report a retrospective, multicenter study of 146 patients with AITL who received ASCT. The source of the stem cells was peripheral blood in 143 patients. The conditioning regimen varied, and 74% of the patients received carmustine and 1,3-bis(2-chloroethyl)-1-nitrosourea; etoposide; ara-C; and melphalan chemotherapy. RESULTS: After a median follow-up of 31 months (range, 3 to 174 months), 95 patients (65%) remained alive, and 51 patients (35%) died. Forty-two patients died as a result of disease progression, and nine died as a result of regimen-related toxicity. The cumulative incidence of nonrelapse mortality was 5% and 7% at 12 and 24 months, respectively. The actuarial overall survival (OS) was 67% at 24 months and 59% at 48 months. The cumulative incidence of relapse was estimated at 40% and 51% at 24 and 48 months, respectively. Disease status at transplantation was the major factor that impacted outcome. Patients who received a transplant during first complete remission (CR) had significantly superior progression-free survival and OS. The estimated PFS rates for patients who received their transplants in CR were 70% and 56% at 24 and 48 months, respectively; 42% and 30% for patients with chemotherapy-sensitive disease at those time points, respectively; and 23% at both time points for patients with chemotherapy-refractory disease. CONCLUSION: This study shows that HDT and ASCT offers the possibility of long-term disease-free survival to patients with AITL. Early transplantation is necessary to achieve optimal results.
PURPOSE:Patients with angioimmunoblastic T-cell lymphoma (AITL) have poor prognoses with current conventional chemotherapy. The aim of this study was to evaluate the effect of high-dose therapy (HDT) followed by autologous stem-cell transplantation (ASCT) on patients with AITL. PATIENTS AND METHODS: We report a retrospective, multicenter study of 146 patients with AITL who received ASCT. The source of the stem cells was peripheral blood in 143 patients. The conditioning regimen varied, and 74% of the patients received carmustine and 1,3-bis(2-chloroethyl)-1-nitrosourea; etoposide; ara-C; and melphalan chemotherapy. RESULTS: After a median follow-up of 31 months (range, 3 to 174 months), 95 patients (65%) remained alive, and 51 patients (35%) died. Forty-two patients died as a result of disease progression, and nine died as a result of regimen-related toxicity. The cumulative incidence of nonrelapse mortality was 5% and 7% at 12 and 24 months, respectively. The actuarial overall survival (OS) was 67% at 24 months and 59% at 48 months. The cumulative incidence of relapse was estimated at 40% and 51% at 24 and 48 months, respectively. Disease status at transplantation was the major factor that impacted outcome. Patients who received a transplant during first complete remission (CR) had significantly superior progression-free survival and OS. The estimated PFS rates for patients who received their transplants in CR were 70% and 56% at 24 and 48 months, respectively; 42% and 30% for patients with chemotherapy-sensitive disease at those time points, respectively; and 23% at both time points for patients with chemotherapy-refractory disease. CONCLUSION: This study shows that HDT and ASCT offers the possibility of long-term disease-free survival to patients with AITL. Early transplantation is necessary to achieve optimal results.
Authors: Andrei R Shustov; Theodore A Gooley; Brenda M Sandmaier; Judith Shizuru; Mohamed L Sorror; Firoozeh Sahebi; Peter McSweeney; Dietger Niederwieser; Benedetto Bruno; Rainer Storb; David G Maloney Journal: Br J Haematol Date: 2010-05-09 Impact factor: 6.998
Authors: A C Mamez; L Souchet; D Roos-Weil; M Uzunov; A L Brun; C Algrin; V Leblond; S Nguyen Journal: Bone Marrow Transplant Date: 2014-11-03 Impact factor: 5.483
Authors: Steven I Park; Steven M Horwitz; Francine M Foss; Lauren C Pinter-Brown; Kenneth R Carson; Steven T Rosen; Barbara Pro; Eric D Hsi; Massimo Federico; Christian Gisselbrecht; Marc Schwartz; Lisa A Bellm; Mark Acosta; Ranjana H Advani; Tatyana Feldman; Mary Jo Lechowicz; Sonali M Smith; Frederick Lansigan; Anil Tulpule; Michael D Craig; John P Greer; Brad S Kahl; Joseph W Leach; Neil Morganstein; Carla Casulo; Andrei R Shustov Journal: Cancer Date: 2019-01-29 Impact factor: 6.860
Authors: Nathalie Mourad; Nicolas Mounier; Josette Brière; Emmanuel Raffoux; Alain Delmer; Alfred Feller; Chris J L M Meijer; Jean-François Emile; Réda Bouabdallah; André Bosly; Jacques Diebold; Corinne Haioun; Bertrand Coiffier; Christian Gisselbrecht; Philippe Gaulard Journal: Blood Date: 2008-02-21 Impact factor: 22.113
Authors: Ulas D Bayraktar; Qaiser Bashir; Muzaffar Qazilbash; Richard E Champlin; Stefan O Ciurea Journal: Biol Blood Marrow Transplant Date: 2012-08-24 Impact factor: 5.742