Long-term disease-free survival in patients with angioimmunoblastic T-cell lymphoma after high-dose chemotherapy and autologous stem cell transplantation.
OBJECTIVE
Patients with angioimmunoblastic T-cell lymphoma (AIL) have a poor prognosis with conventional treatment.


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.


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.
Schetelig
Johannes
J
Klinik für Innere Medizin m. S. Hämatologie und Onkologie, Humboldt Universität, Germany.
Fetscher
Sebastian
S
Reichle
Albrecht
A
Berdel
Wolfgang E
WE
Beguin
Yves
Y
Brunet
Salut
S
Caballero
Dolores
D
Majolino
Ignazio
I
Hagberg
Hans
H
Johnsen
Hans E
HE
Kimby
Eva
E
Montserrat
Emilio
E
Stewart
Douglas
D
Copplestone
Adrian
A
Rösler
Wolf
W
Pavel
Jindra
J
Kingreen
Dorothea
D
Siegert
Wolfgang
W
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006306:Health Surveys; D006801:Humans; D007119:Immunoblastic Lymphadenopathy / Q000188:drug therapy* / Q000401:mortality / Q000628:therapy; D015993:Life Tables; D016399:Lymphoma, T-Cell / Q000188:drug therapy* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation; D012074:Remission Induction; D012189:Retrospective Studies; D016879:Salvage Therapy; D016019:Survival Analysis; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous; D016896:Treatment Outcome