Kim Tong-Yoon, Kim Tae-Jung, Han Eun Ji, Min Gi June, Cho Seok-Goo, Jeon Youngwoo
Department of Hematology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Lymphoma and Cell Therapy Research Center, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Front Oncol. 2024 Dec 9;14:1461268. doi: 10.3389/fonc.2024.1461268. eCollection 2024.
Peripheral T-cell lymphomas (PTCLs) have poor outcomes in the relapsed/refractory (R/R) setting. In this study, we evaluated the efficacy of dexamethasone, L-asparaginase, ifosfamide, carboplatin, and etoposide (DL-ICE) chemotherapy followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with R/R PTCLs.
We retrospectively analyzed 80 adult patients with R/R PTCLs treated with DL-ICE chemotherapy between September 2009 and March 2023. Patients achieving complete or partial remission were eligible for consolidative allo-HSCT. Overall survival (OS) and progression-free survival (PFS) were evaluated.
The overall response rate to DL-ICE was 37.5%, with 30% achieving complete remission (CR). With a median follow-up of 96.4 months, the median OS and PFS were 8.9 and 3.8 months, respectively. Seventeen patients (21%) underwent allo-HSCT, including 11 with non-CR status. The 5-year OS was significantly higher in the allo-HSCT group compared to that in the group with chemotherapy alone (64.7% vs 18.3%, p <0.001). Multivariate analysis identified advanced stage, EBV viremia, and non-CR status as poor prognostic factors.
DL-ICE chemotherapy demonstrated modest activity in R/R PTCLs. Consolidation with allo-HSCT, even in patients who do not achieve CR, resulted in long-term survival in a subset of patients. Early consideration of allo-HSCT may improve outcomes for patients with R/R PTCLs.
外周T细胞淋巴瘤（PTCLs）在复发/难治性（R/R）情况下预后较差。在本研究中，我们评估了地塞米松、L-天冬酰胺酶、异环磷酰胺、卡铂和依托泊苷（DL-ICE）化疗后进行异基因造血干细胞移植（allo-HSCT）对R/R PTCLs患者的疗效。
我们回顾性分析了2009年9月至2023年3月期间接受DL-ICE化疗的80例成年R/R PTCLs患者。达到完全或部分缓解的患者有资格接受巩固性allo-HSCT。评估总生存期（OS）和无进展生存期（PFS）。
DL-ICE的总体缓解率为37.5%，30%达到完全缓解（CR）。中位随访96.4个月，中位OS和PFS分别为8.9个月和3.8个月。17例患者（21%）接受了allo-HSCT，其中11例为非CR状态。allo-HSCT组的5年OS显著高于单纯化疗组（64.7%对18.3%，p<0.001）。多变量分析确定晚期、EBV病毒血症和非CR状态为不良预后因素。
DL-ICE化疗在R/R PTCLs中显示出适度的活性。即使在未达到CR的患者中，进行allo-HSCT巩固治疗也能使一部分患者获得长期生存。早期考虑allo-HSCT可能改善R/R PTCLs患者的预后。
