Prolonged survival of patients with angioimmunoblastic T-cell lymphoma after high-dose chemotherapy and autologous stem cell transplantation: the GELTAMO experience.
OBJECTIVE
Angioimmunoblastic T-cell lymphoma (AIL) is a rare lymphoma with a poor prognosis and no standard treatment. Here, we report our experiences with 19 patients treated with high-dose chemotherapy and autologous stem cell transplantation (HDC/ASCT) within the GELTAMO co-operative group between 1992 and 2004.


METHODS
The median age at transplantation was 46 yr. Fifteen patients underwent the procedure as front-line therapy and four patients as salvage therapy. Most patients received peripheral stem cells (90%) coupled with BEAM or BEAC as conditioning regimen (79%).


RESULTS
A 79% of patients achieved complete response, 5% partial response and 16% failed the procedure. After a median follow-up of 25 months, eight patients died (seven of progressive disease and secondary neoplasia), while actuarial overall survival and progression-free survival at 3 yr was 60% and 55%. Prognostic factors associated with a poor outcome included bone marrow involvement, transplantation in refractory disease state, attributing more than one factor of the age-adjusted-International Prognostic Index, Pretransplant peripheral T-cell lymphoma (PTCL) Score or Prognostic Index for PTCL.


CONCLUSIONS
More than half of the patients with AIL that display unfavourable prognostic factors at diagnosis or relapse would be expected to be alive and disease-free after 3 yr when treated with HDC/ASCT. Patients who are transplanted in a refractory disease state do not benefit from this procedure.
Rodríguez
José
J
Hospital Universitario Son Dureta, Palma de Mallorca, Spain. jrodriguez@hsd.es
Conde
Eulogio
E
Gutiérrez
Antonio
A
Arranz
Reyes
R
Gandarillas
Marcos
M
Leon
Angel
A
Ojanguren
Jesus
J
Sureda
Anna
A
Carrera
Dolores
D
Bendandi
Mauricio
M
Moraleda
Jose
J
Ribera
Jose Maria
JM
Albo
Carmen
C
Morales
Alfonso
A
García
Juan Carlos
JC
Fernández
Pascual
P
Cañigral
Guillermo
G
Bergua
Juan
J
Caballero
María Dolores
MD
D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D018450:Disease Progression; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007119:Immunoblastic Lymphadenopathy / Q000175:diagnosis / Q000628:therapy*; D016411:Lymphoma, T-Cell, Peripheral / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012042:Registries; D012720:Severity of Illness Index; D013030:Spain; D015996:Survival Rate; D014182:Transplantation, Autologous; D016896:Treatment Outcome