title: Frontline autologous stem cell transplantation in high-risk peripheral T-cell lymphoma: a prospective study from The Gel-Tamo Study Group.
abstract: OBJECTIVE
  Retrospective data shows that peripheral T-cell lymphoma (PTCL) patients sensitive to conventional chemotherapy for aggressive lymphomas may respond better if this treatment is consolidated with frontline autologous stem cell transplantation (ASCT). Here, we present data from a prospective phase II trial of high-dose chemotherapy and ASCT as a frontline consolidation therapy for aggressive nodal PTCL.
  
  
  METHODS
  This study involved 26 gallium-scan-positive patients with high-risk nodal PTCL [excluding anaplastic lymphoma kinase (ALK) positive]. Patients received three courses of MegaCHOP before they were evaluated, and those that were gallium-scan-negative at this stage then received another course of MegaCHOP and ASCT. Patients who remained gallium-scan-positive received two courses of an IFE regimen (ifosfamide 10 g/m(2), etoposide 150 mg/m(2)/12 h on days 1-3) and if they at least achieved PR, they then received the transplant.
  
  
  RESULTS
  Complete response (CR) was achieved by 12 patients (46%) after three courses of MegaCHOP and 12 patients received IFE as a salvage therapy. After the ASCT (n = 19), 89% of patients achieved CR. In contrast, six patients (23%) did not receive the transplant because of the progression of the disease (n = 5) or lethal toxicity (n = 1). One patient in first-line CR refused ASCT. After a median follow-up of 35 months, the overall survival (OS) and progression-free survival (PFS) at 3 yr was 73% and 53%, respectively. Moreover, the OS, PFS and disease-free survival (DFS) were 84%, 56% and 63%, respectively 2 yr after transplant in patients who received ASCT consolidation (n = 19).
  
  
  CONCLUSIONS
  Early salvage therapy for patients with high-risk aggressive nodal PTCL that do not achieve CR after three courses of chemotherapy and ASCT frontline consolidation for chemosensitive patients may improve treatment outcome.
authors.affiliation: Hospital Universitario Son Dureta, Palma, Spain. jrodriguez@hsd.es
authors.forename: José
authors.initials: J
authors.lastname: Rodríguez
authors.forename: Eulogio
authors.initials: E
authors.lastname: Conde
authors.forename: Antonio
authors.initials: A
authors.lastname: Gutiérrez
authors.forename: Reyes
authors.initials: R
authors.lastname: Arranz
authors.forename: Angel
authors.initials: A
authors.lastname: León
authors.forename: Julián
authors.initials: J
authors.lastname: Marín
authors.forename: Maurizio
authors.initials: M
authors.lastname: Bendandi
authors.forename: Carmen
authors.initials: C
authors.lastname: Albo
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Caballero
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D016399:Lymphoma, T-Cell / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D033581:Stem Cell Transplantation; D016019:Survival Analysis; D019172:Transplantation Conditioning