title: Disappointing outcome of autologous stem cell transplantation for enteropathy-associated T-cell lymphoma.
abstract: BACKGROUND
  Despite treatment, enteropathy-associated T-cell lymphoma has a very poor outcome. Chemotherapy can be complicated by small bowel perforation, gastrointestinal bleeding and development of enterocolic fistulae. Here we report on the feasibility, safety and efficacy of high-dose chemotherapy followed by autologous stem cell transplantation in patients with enteropathy-associated T-cell lymphoma (three upfront and one at relapse), with or without prior partial small bowel resection.
  
  
  METHODS
  Four patients [two males, two females, mean age 65 years (range 60-69 years)] received high-dose chemotherapy followed by autologous stem cell transplantation. Partial small bowel resection has been performed in three patients.
  
  
  RESULTS
  All four patients completed the mobilization and leucopheresis procedures successfully and subsequently received conditioning chemotherapy and transplantation. Engraftment occurred in all patients. No major non-haematological toxicity or transplantation-related mortality was observed. One patient has ongoing complete remission 32 months after transplantation. Three patients died from relapse within few months after autologous stem cell transplantation.
  
  
  CONCLUSIONS
  Autologous stem cell transplantation seems unsatisfactory for patients with enteropathy-associated T-cell lymphoma. More intensive conditioning and aggressive chemotherapy with/or without targeted immunotherapy as well as allogenous stem cell transplantation needs to be explored.
authors.affiliation: Department of Gastroenterology, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Al-Toma
authors.forename: W H M
authors.initials: WH
authors.lastname: Verbeek
authors.forename: O J
authors.initials: OJ
authors.lastname: Visser
authors.forename: K C
authors.initials: KC
authors.lastname: Kuijpers
authors.forename: J J
authors.initials: JJ
authors.lastname: Oudejans
authors.forename: H C
authors.initials: HC
authors.lastname: Kluin-Nelemans
authors.forename: C J J
authors.initials: CJ
authors.lastname: Mulder
authors.forename: P C
authors.initials: PC
authors.lastname: Huijgens
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D002446:Celiac Disease / Q000150:complications* / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007082:Ileum / Q000473:pathology; D016399:Lymphoma, T-Cell / Q000150:complications* / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D036102:Peripheral Blood Stem Cell Transplantation; D012074:Remission Induction; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous; D016896:Treatment Outcome