title: First-line therapy of peripheral T-cell lymphoma: extension and long-term follow-up of a study investigating the role of autologous stem cell transplantation.
abstract: Current guidelines recommend consolidation with autologous stem cell transplantation (autoSCT) after induction chemotherapy for most patients with peripheral T-cell lymphoma (PTCL). This assumption is based on five prospective phase II studies, three of which included <50 patients with limited follow-up. Here we present the final analysis of the prospective German study. The treatment regimen consisted of four to six cycles of CHOP chemotherapy followed by mobilizing therapy and stem cell collection. Patients in complete remission (CR) or partial remission (PR) underwent myeloablative chemo(radio)therapy and autoSCT. From January 2001 to July 2010, 111 patients were enrolled in the study. The main subgroups were PTCL not specified (n=42) and angioimmunoblastic T-cell lymphoma (n=37). Seventy-five (68%) of the 111 patients received transplantation. The main reason for not receiving autoSCT was progressive disease. In an intent-to-treat analysis, the complete response rate after myeloablative therapy was 59%. The estimated 5-year overall survival, disease-free survival and progression-free survival rates were 44%, 54% and 39%, respectively. The results of this study confirm that upfront autoSCT can result in long-term remissions in patients with all major subtypes of PTCL and therefore should be part of first-line therapy whenever possible.
authors.affiliation: Hematology and Medical Oncology Clinic, Paracelsus Medical University Nuernberg, Nürnberg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Wilhelm
authors.affiliation: Hematology and Medical Oncology Clinic, Paracelsus Medical University Nuernberg, Nürnberg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Smetak
authors.affiliation: Evang. Krankenhaus Essen-Werden, Clinic for Hematology, Medical Oncology and Stem Cell Transplantation, Pattbergstr, Essen, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Reimer
authors.affiliation: Institute of Pathology, University of Wuerzburg, Comprehensive Cancer Center Mainfranken, Würzburg, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Geissinger
authors.affiliation: Institute of Pathology, Karlsruhe, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Ruediger
authors.affiliation: University Clinic for Internal Medicine - Hematology and Oncology Clinic, Klinikum Oldenburg, Oldenburg, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Metzner
authors.affiliation: Asklepios Hospital St. Georg, Hematology Department, Hamburg, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Schmitz
authors.affiliation: University Hospital of Cologne, Internal Medicine I, Köln, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Engert
authors.affiliation: Hematology and Medical Oncology Clinic, Paracelsus Medical University Nuernberg, Nürnberg, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Schaefer-Eckart
authors.affiliation: Hematology and Medical Oncology Clinic, Paracelsus Medical University Nuernberg, Nürnberg, Germany.
authors.forename: J
authors.identifier: 0000-0002-1103-9838
authors.initials: J
authors.lastname: Birkmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000627:therapeutic use; D018450:Disease Progression; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006801:Humans; D053208:Kaplan-Meier Estimate; D016411:Lymphoma, T-Cell, Peripheral / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011241:Prednisone / Q000627:therapeutic use; D012074:Remission Induction; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014750:Vincristine / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone