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Schmitz, Norbert; Truemper, Lorenz H; Bouabdallah, Krimo; Ziepert, Marita; Leclerc, Mathieu; Cartron, Guillaume; Jaccard, Arnaud; Reimer, Peter; Wagner-Drouet, Eva Maria; Wilhelm, Martin; Sanhes, Laurence; Lamy, Thierry; de Leval, Laurence; Rosenwald, Andreas; Roussel, Murielle; Kroschinsky, Frank P; Lindemann, Walter Walter; Dreger, Peter; Viardot, Andreas; Milpied, Noel J; Gisselbrecht, Christian; Wulf, Gerald G; Gyan, Emmanuel; Gaulard, Philippe; [...]

A randomized phase 3 trial of auto vs. allo transplantation as part of first-line therapy in poor-risk peripheral T-NHL

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  • Media type: E-Article
  • Title: A randomized phase 3 trial of auto vs. allo transplantation as part of first-line therapy in poor-risk peripheral T-NHL
  • Contributor: Schmitz, Norbert; Truemper, Lorenz H; Bouabdallah, Krimo; Ziepert, Marita; Leclerc, Mathieu; Cartron, Guillaume; Jaccard, Arnaud; Reimer, Peter; Wagner-Drouet, Eva Maria; Wilhelm, Martin; Sanhes, Laurence; Lamy, Thierry; de Leval, Laurence; Rosenwald, Andreas; Roussel, Murielle; Kroschinsky, Frank P; Lindemann, Walter Walter; Dreger, Peter; Viardot, Andreas; Milpied, Noel J; Gisselbrecht, Christian; Wulf, Gerald G; Gyan, Emmanuel; Gaulard, Philippe; [...]
  • imprint: American Society of Hematology, 2020
  • Published in: Blood
  • Language: English
  • DOI: 10.1182/blood.2020008825
  • ISSN: 1528-0020; 0006-4971
  • Origination:
  • Footnote:
  • Description: <jats:p>Standard first-line therapy for younger patients with peripheral T-cell lymphoma consists of six courses of CHOP or CHOEP consolidated by high-dose therapy and autologous stem cell transplantation (AutoSCT). We hypothesized that consolidative allogeneic transplantation (AlloSCT) could improve outcome. 104 patients with nodal peripheral T-cell lymphoma except ALK+ ALCL, 18 to 60 years of age, all stages and IPI scores except stage 1 and aaIPI 0, were randomized to receive 4 x CHOEP and 1 x DHAP followed by high-dose therapy and AutoSCT or myeloablative conditioning and AlloSCT. The primary endpoint was event-free survival (EFS) at three years. After a median follow-up of 42 months, 3-year EFS of patients undergoing AlloSCT was 43% (95% confidence interval [CI]: 29%; 57%) as compared to 38% (95% CI: 25%; 52%) after AutoSCT. Overall survival at 3 years was 57% (95% CI: 43%; 71%) versus 70% (95% CI: 57%; 82%) after AlloSCT or AutoSCT, without significant differences between treatment arms. None of 21 responding patients proceeding to AlloSCT as opposed to 13 of 36 patients (36%) proceeding to AutoSCT relapsed. Eight of 26 patients (31%) and none of 41 patients died due to transplant-related toxicity after allogeneic and autologous transplantation, respectively. In younger patients with T-cell lymphoma standard chemotherapy consolidated by autologous or allogeneic transplantation results in comparable survival. The strong graft-versus-lymphoma effect after AlloSCT was counterbalanced by transplant-related mortality. CHO(E)P followed by AutoSCT remains the preferred treatment option for transplant-eligible patients. AlloSCT is the treatment of choice for relapsing patients also after AutoSCT.</jats:p>
  • Access State: Open Access