Risk factors and timing of autologous stem cell transplantation for patients with peripheral T-cell lymphoma

Satoshi Yamasaki, Dai Chihara, Sung Won Kim, Takahito Kawata, Shuichi Mizuta, Hiroatsu Ago, Takaaki Chou, Takahisa Yamane, Hitoji Uchiyama, Tatsuo Oyake, Katsuhiro Miura, Bungo Saito, Hirofumi Taji, Hirohisa Nakamae, Toshihiro Miyamoto, Takahiro Fukuda, Junya Kanda, Yoshiko Atsuta, Ritsuro Suzuki

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Abstract

High-dose chemotherapy with autologous stem cell transplantation (HDC-ASCT) is an option for patients with peripheral T-cell lymphoma (PTCL); however, neither prospective nor retrospective studies support proceeding with ASCT upfront, and the timing of HDC-ASCT remains controversial. We retrospectively analyzed the risk factors for outcomes of 570 patients with PTCL, including PTCL not otherwise specified (PTCL-NOS) and angioimmunoblastic T-cell lymphoma (AITL), who received ASCT for frontline consolidation (n = 98 and 75, respectively) or alternative therapies after either relapse (n = 112 and 75) or primary induction failure (PIF; n = 127 and 83) between 2000 and 2015. Significant risk factors for overall survival (OS) after upfront ASCT were a ≥ 2 prognostic index for T-cell lymphoma (P < 0.001) and partial response (PR) at ASCT (P = 0.041) in PTCL-NOS patients, and > 60 years of age (P = 0.0028) and PR at ASCT (P = 0.0013) in AITL patients. Performance status of ≥ 2 at ASCT (P < 0.001), receiving ≥ 3 regimens before ASCT (P = 0.018), and PR at ASCT (P = 0.018) in PTCL-NOS patients and > 60 years of age at ASCT (P = 0.0077) in AITL patients were risk factors for OS after ASCT with a chemosensitive PIF status. Strategies that carefully select PTCL patients may allow identification of individuals suitable for ASCT.

Original languageEnglish
Pages (from-to)175-186
Number of pages12
JournalInternational journal of hematology
Volume109
Issue number2
DOIs
Publication statusPublished - Feb 20 2019

All Science Journal Classification (ASJC) codes

  • Hematology

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    Yamasaki, S., Chihara, D., Kim, S. W., Kawata, T., Mizuta, S., Ago, H., Chou, T., Yamane, T., Uchiyama, H., Oyake, T., Miura, K., Saito, B., Taji, H., Nakamae, H., Miyamoto, T., Fukuda, T., Kanda, J., Atsuta, Y., & Suzuki, R. (2019). Risk factors and timing of autologous stem cell transplantation for patients with peripheral T-cell lymphoma. International journal of hematology, 109(2), 175-186. https://doi.org/10.1007/s12185-018-2560-x