title: The role of high dose chemotherapy and autologous stem-cell transplantation in peripheral T-cell lymphoma: a review of the literature and new perspectives.
abstract: Peripheral T-cell lymphoma (PTCL) is a heterogeneous group of non-Hodgkin's lymphoma that carries, except for ALK-positive anaplastic large cell lymphoma, a poor prognosis. Only a third of patients live 5years past diagnosis. The incidence of PTCL has been increasing during the last two decades. In recent years, there was a rising interest in PTCL manifested by the abundance of publications dedicated exclusively to this disease. The international T-cell lymphoma project was formed with an aim of unifying efforts towards a better understanding of the diagnosis and management of this disease. Given the poor outcomes of PTCL patients, high-dose chemotherapy and autologous stem-cell transplantation (HDT/ASCT) have been used in the up-front and salvage settings, with different success rates. However, there are no prospective randomized controlled trials addressing the role of HDT/ASCT in a PTCL-restricted population. This article critically reviews the data available from the retrospective and prospective studies addressing this topic. We will emphasize the favorable prognostic factors of HDT/ASCT such as a solid remission at the time of transplantation, a chemotherapy sensitive disease and a low prognostic index score. As novel agents and new therapeutic strategies are introduced, there is a continued need for prospective randomized trials to define the optimal use of HDT/ASCT in managing PTCL.
authors.affiliation: University of Maryland Greenebaum Cancer Center, Baltimore, MD 21201-1595, United States. Jyared@umm.edu
authors.forename: Jean
authors.initials: J
authors.lastname: Yared
authors.forename: Amy
authors.initials: A
authors.lastname: Kimball
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D006801:Humans; D016399:Lymphoma, T-Cell / Q000188:drug therapy* / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D033581:Stem Cell Transplantation / Q000379:methods*; D014182:Transplantation, Autologous