title: Primary treatment response rather than front line stem cell transplantation is crucial for long term outcome of peripheral T-cell lymphomas.
abstract: Outcome of systemic peripheral T-cell lymphomas (PTCL) is unsatisfactory and no controlled clinical study guides the therapy. Phase II studies suggest to consolidate response achieved after front-line treatment with stem cell transplant (SCT). We retrospectively evaluate the impact of front-line SCT consolidation in a single Center cohort of 209 patients treated during the last two decades. Median age was 49 years (range 15-85) with a prevalence of male sex (61%), advanced stage (68%) while IPI was >2 in 44%. Primary treatment was MACOP-B (39%) CHO(E)P (39%), intensive regimens (18%) or others (4%). Complete response to primary treatment (i.e. before SCT) was 60% (5% partial remission). Forty-four patients further proceeded to SCT while 92 did not receive consolidation. Outcome of primary responders was good, with a 3-year overall survival of 74% (82% in ALCL ALK+ and 69% for the other histologies). By multivariate analysis a better overall survival was significantly associated with IPI<2 (P=0.001), primary response (P=0.000), and ALCL ALK+ (P=0.012). The multivariate analysis performed on responders, showed that only IPI was predictive of a better survival while ALCL ALK+ and undergoing SCT were not. Response to primary treatment rather than post-remission programs is the crucial determinant of PTCL outcome.
authors: Hematology and Bone Marrow Transplant Units, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy.
authors: Giuseppe
authors: G
authors: Gritti
authors: Hematology and Bone Marrow Transplant Units, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy.
authors: Cristina
authors: C
authors: Boschini
authors: Hematology and Bone Marrow Transplant Units, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy.
authors: Andrea
authors: A
authors: Rossi
authors: Hematology and Bone Marrow Transplant Units, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy.
authors: Federica
authors: F
authors: Delaini
authors: Hematology and Bone Marrow Transplant Units, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy.
authors: Anna
authors: A
authors: Grassi
authors: Hematology and Bone Marrow Transplant Units, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy.
authors: Alessandra
authors: A
authors: Algarotti
authors: Hematology and Bone Marrow Transplant Units, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy.
authors: Caterina
authors: C
authors: Micò
authors: Pathology Unit, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy.
authors: Rosangela
authors: R
authors: Trezzi
authors: Pathology Unit, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy.
authors: Andrea
authors: A
authors: Gianatti
authors: Hematology and Bone Marrow Transplant Units, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy.
authors: Anna Maria
authors: AM
authors: Barbui
authors: Hematology and Bone Marrow Transplant Units, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy.
authors: Alessandro
authors: A
authors: Rambaldi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016411:Lymphoma, T-Cell, Peripheral / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult