High-dose therapy combined with autologous peripheral blood stem cell transplantation in patients with peripheral T-cell lymphoma: A retrospective study / 肿瘤

ABSTRACT

Objective: To explore the value of high-dose therapy/autologous hematopoietic stem cell transplantation (HDT/AHSCT) in the treatment of patients with peripheral T-cell lymphoma (PTCL). Methods: The medical records of 50 patients with PTCL who received HDT/AHSCT were retrospectively analyzed. The followed-up was performed. Results: No HDT/AHSCT-related death occurred. The median follow-up time was 13 months (range 1-136). The 2-year progression-free survival (PFS) and 2-year overall survival (OS) were 59.0% and 65.0%, respectively. Univariate analysis showed that the patients achieving complete remission (CR) before HDT/AHSCT had superior 2-year PFS and 2-year OS as compared with those of the patients not achieving CR (2-year PFS 72.8% vs 41.9%, P = 0.003; 2-year OS 88.2% vs 41.9%, P = 0.002). The 2-year PFS was 76.8% for the patients who were sensitive to the firstline treatment (CR1/PR1) as compared with 30.8% for the patients who were sensitive to the secondline treatment (CR2/PR2) (P = 0.001). The 2-year OS for patients achieving CR1/PR1was also much better than that for patients achieving CR2/PR2 (81.1% vs 46.2%, P = 0.015). Furthermore, Erythrocyte sedimentation rate (ESR) before transplantation was an important factor for 2-year PFS and 2-year OS (P = 0.004, P = 0.018). Serum lactate dehydrogenase (LDH) level before transplantation was another important factor for 2-year PFS (P = 0.044). Multivariate analysis showed that the therapeutic response (achieving CR) before transplantation was an independent factor for 2-year OS [risk ratio 4.879 (95% confidence interval 1.583-15.034), P = 0.006]. No independent factors for 2-year PFS were observed. Subgroup analysis revealed that the patients with angioimmunoblastic T-cell lymphoma and advanced natural killer (NK)/T-cell lymphoma who received HDT/AHSCT during first CR may have benefit in survival from HDT/AHSCT. Conclusion: HDT/AHSCT can be used as safe and effective first-line consolidation therapy or salvage therapy in patints with PTCL and partially improve the prognosis. Prospective randomized controlled trials are necessary to confirm the suitable pathologic subtype and the best pretransplantation status for HDT/AHSCT.