title: Intensified chemo-immunotherapy with or without stem cell transplantation in newly diagnosed patients with peripheral T-cell lymphoma.
abstract: Peripheral T-cell lymphomas (PTCLs) receiving conventional treatment have a poor clinical outcome. We conducted a phase II study to evaluate the feasibility and efficacy of chemo-immunotherapy in young (⩽60 years old, Clin A study) and elderly (>60 and < or =75 years old, Clin B study) patients with newly diagnosed PTCL. Clin A patients (n=61) received two courses of CHOP (cyclophosphamide, adriamycin, vincristine, prednisone)-21 with alemtuzumab (AL, 30 mg) followed by two courses of high-dose chemotherapy. On the basis of donor availability, patients in response received allogeneic (allo) or autologous (auto) stem cell transplantation (SCT). Clin B patients (n=25) received six courses of CHOP-21 and AL (10 mg). Clin A responding patients were 38 of 61 (62%) and received alloSCT (n=23) or autoSCT (n=14); one complete remission (CR) patient was not transplanted. At a median follow-up of 40 months, the 4-year overall survival (OS), progression-free survival (PFS) and disease-free survival (DFS) rates were 49, 44 and 65%, respectively. In Clin B study, the response rate was 72%. At a median follow-up of 48 months, the 4-year OS, PFS and DFS rates were 31, 26 and 44%, respectively. In conclusion, front-line alloSCT or autoSCT is effective in prolonging DFS in young patients; AL in elderly improved response with no survival benefit.
authors.affiliation: 1] Division of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy [2] University of Milan, Milano, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Corradini
authors.affiliation: Division of Hematology, Ospedale San Giovanni Battista, Torino, Italy.
authors.forename: U
authors.initials: U
authors.lastname: Vitolo
authors.affiliation: Division of Hematology and Bone Marrow Transplant Unit, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Rambaldi
authors.affiliation: Department of Medical Statistics, Biometry and Bioinformatics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Miceli
authors.affiliation: Department of Hematology, University of Udine, Udine, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Patriarca
authors.affiliation: Department of Hematology, Azienda Ospedaliera Santa Croce e Carle, Cuneo, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Gallamini
authors.affiliation: Department of Hematology, Ospedale Umberto-Torrette di Ancona, University of Ancona, Ancona, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Olivieri
authors.affiliation: Department of Hematology, Policlinico G.B. Rossi, Verona, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Benedetti
authors.affiliation: Department of Hematology, Policlinico G.B. Rossi, Verona, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Todeschini
authors.affiliation: Department of Hematology, Ospedale di Brescia, Brescia, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Rossi
authors.affiliation: Department of Hematology, Ospedale di Alessandria, Alessandria, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Salvi
authors.affiliation: Division of Hematology, Ospedale San Giovanni Battista, Torino, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Bruno
authors.affiliation: Department of Hematology, Fondazione IRCCS Ca' Granda OM Policlinico and University of Milano, Milano, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Baldini
authors.affiliation: Department of Oncology, Ospedale San Raffaele, Milano, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Ferreri
authors.affiliation: Department of Bone Marrow Transplantation, Azienda Ospedaliera Ospedali Riuniti, Villa Sofia, Cervello, Palermo, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Patti
authors.affiliation: Department of Hematology, Azienda Ospedaliera Mauriziano, Torino, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Tarella
authors.affiliation: Department of Anatomic-Pathology, University of Bologna, Bologna, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Pileri
authors.affiliation: Division of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Dodero
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007167:Immunotherapy; D016411:Lymphoma, T-Cell, Peripheral / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models