Abramson Cancer Center and the Division of Hematology and Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Am J Hematol. 2016 Jul;91(7):672-6. doi: 10.1002/ajh.24372. Epub 2016 Apr 24.
Patients with peripheral T cell lymphomas (PTCL) generally have a poor prognosis when treated with conventional chemotherapy. Consolidation with autologous stem cell transplantation (ASCT) has been reported to improve progression-free survival. However, these studies have not compared consolidative ASCT with active observation in patients with PTCL achieving first complete remission (CR1) following induction chemotherapy. We conducted a retrospective analysis of PTCL patients treated at the University of Pennsylvania between 1/1/2007 and 12/31/2014. Patients with cutaneous T cell lymphoma, concurrent B cell lymphomas, and anaplastic lymphoma kinase-positive anaplastic large cell lymphoma (ALK-positive ALCL) were excluded from the study. We compared progression-free survival for patients who underwent ASCT in CR1 following CHOP-like induction regimens and patients who underwent active observation during CR1. 48 patients met all inclusion and exclusion criteria and underwent either active observation (28 patients) or consolidative ASCT (20 patients) in CR1. The 1-year cumulative incidence of relapse in the observation and ASCT groups was 50% (95% confidence interval [CI]: 30-67%) and 46% (95% CI: 23-67%), respectively (P = 0.55). Median progression-free survival in the observation and ASCT groups was 15.8 and 12.8 months, respectively (log rank, P = 0.79). Estimated 3-year progression-free survival in the observation and ASCT groups was 37 and 41%, respectively. In conclusion, for PTCL patients achieving CR1 following CHOP-like induction chemotherapy, ASCT does not appear to improve progression-free survival compared to active observation. This finding should be confirmed in a larger, prospective study. Am. J. Hematol. 91:672-676, 2016. © 2016 Wiley Periodicals, Inc.
患者外周 T 细胞淋巴瘤 (PTCL) 一般具有不良预后时，用常规化疗。巩固与自体造血干细胞移植 (ASCT) 已被报道改善无进展生存期。然而，这些研究没有比较巩固性 ASCT 与积极的观察在患者 PTCL 实现第一次完全缓解 (CR1) 后诱导化疗。我们进行了回顾性分析 PTCL 患者在宾夕法尼亚大学治疗 1/1/2007 年至 12/31/2014 年。患者皮肤 T 细胞淋巴瘤、并发 B 细胞淋巴瘤和间变性淋巴瘤激酶阳性间变性大细胞淋巴瘤 (ALK 阳性 ALCL) 从研究中排除。我们比较无进展生存为患者接受 ASCT 在 CR1 后 CHOP 样诱导方案和患者接受积极的观察在 CR1。48 例符合所有纳入和排除标准，并接受积极的观察 (28 例) 或巩固性 ASCT (20 例) 在 CR1。1 年累积复发率观察和 ASCT 组分别为 50%（95%可信区间[CI]：30-67%）和 46%（95% CI：23-67%），分别（P=0.55）。无进展生存的中位数观察和 ASCT 组分别为 15.8 和 12.8 个月，分别（对数秩，P=0.79）。估计 3 年无进展生存率在观察和 ASCT 组分别为 37%和 41%。总之，对于 PTCL 患者实现 CR1 后 CHOP 样诱导化疗，ASCT 似乎没有改善无进展生存率与积极的观察。这一发现应该在更大的前瞻性研究中得到证实。美国 J 血液学。91:672-676，2016。© 2016 年威利期刊公司。
