• Medientyp: E-Artikel
  • Titel: Autologous and Allogeneic Stem Cell Transplantation for T-Cell Lymphoma: The M.D. Anderson Cancer Center Experience,
  • Beteiligte: Beitinjaneh, Amer; Saliba, Rima M.; Okoroji, Grace-Julia; Korbling, Martin; Alousi, Amin M; Popat, Uday; Anderlini, Paolo; Bashir, Qaiser; Andersson, Borje S; Kebriaei, Partow; Hosing, Chitra M; Qazilbash, Muzaffar; Fanale, Michelle A.; Pro, Barbara; Champlin, Richard; Khouri, Issa
  • Erschienen: American Society of Hematology, 2011
  • Erschienen in: Blood
  • Umfang: 4118-4118
  • Sprache: Englisch
  • DOI: 10.1182/blood.v118.21.4118.4118
  • ISSN: 0006-4971; 1528-0020
  • Schlagwörter: Cell Biology ; Hematology ; Immunology ; Biochemistry
  • Zusammenfassung: <jats:title>Abstract</jats:title> <jats:p>Abstract 4118</jats:p> <jats:sec> <jats:title>BACKGROUND:</jats:title> <jats:p>Despite the advent of novel agents, outcomes of T cell Lymphoma (TCL) with conventional chemotherapy are poor. We have previously reported (Rodriguez J, JCO 2001) encouraging results with autologous stem cell transplantation (ASCT). Others have advocated allogeneic transplants (Allo-SCT). Herein, we report our long-term experience in 196 TCL patients (pts) who had either ASCT (n=119) or Allo-SCT (n=77).</jats:p> </jats:sec> <jats:sec> <jats:title>METHOD and PATIENTS:</jats:title> <jats:p>This is a retrospective analysis of TCL pts treated with SCT at our institution between 1986 and 2009. We adopted WHO 2008 classification for TCL and divided pts accordingly into Nodal TCL (N-TCL), extra nodal TCL (EN-TCL), and T cell lymphoblastic Lymphoma (T-LBL). Sixty one pts (31%) had peripheral t-cell not otherwise specified (PTCL), 50 (26%) had anaplastic large cell (ALCL), 19 (10%) angioimmunoblatic (AITL), 34 (17%) EN-TCL, and 32 (16%) had T-LBL. ASCT and Allo-SCT pts were balanced for Ann-Arbor stage, gender distribution and time from initial diagnosis. However, Allo-SCT pts were younger (median age 41 vs. 49 yrs, respectively, (p=0.002), more heavily pretreated (p=0.01), were more likely to have extranodal (p&lt;0.001) or bone marrow involvement (p=0.001), and refractory disease (p=0.01) at the time of transplant.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS: A. [ASCT]:</jats:title> <jats:p>Most pts (82%)received BEAM-like conditioning. With a median follow-up of 39 months (range, 3–208), the OS and PFS rates were 39% and 30%, respectively. Risk factors for OS and PFS were evaluated among the largest histologic subgroups, i.e., PTCL, ALCL and AITL: among those 94 pts who received ASCT, having a transplant &gt; CR1 (p=0.001), Prognostic Index for TCL(PIT) &gt;0 (p=0.009), IPI&gt;1 (p=0.03), refractory disease (p=0.001) were associated with worse OS and PFS (Figure 1). The 3-year OS and PFS for CR1 pts (n+33) were 90% and 70%, respectively. A subset of pts (n= 11) within the CR1 group received induction chemotherapy with Hyper-CVAD before ASCT. The 3-year OS and PFS rates for these pts were both 100%. We were not able to detect any difference in outcomes between the different histologies studied, including ALK(+) and ALK (−) ALCL. B. [Allo-SCT] Most pts (75%) received myeloablative conditioning. There was a trend for better outcomes for transplants &gt; year 2000. With a median follow-up of 65 months (range, 5–235), the OS and PFS rates were 43% and 30%, respectively. OS and PFS rates for EN-TCL(n=18) were 49% and 36%, respectively. Among the N-TCL (n=33) group, unlike ASCT, most pts (87%) were &gt;CR1. The 3-year OS and PFS rates for these pts were 38% and 23%, respectively. Both IPI and PIT &gt;0 were determinants for worse PFS, whereas IPI &gt;0 and marrow involvement were predictors for worse OS. No plateau however was observed in these pts, unlike those with T-LBL, where a clear plateau of 40 % was observed.</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSION:</jats:title> <jats:p>This is the largest single institution analysis to investigate the role of SCT for TCL. Our review demonstrates that ASCT can induce long-term remissions in CR1 pts with N-TCL. Prospective studies comparing ASCT in this setting to other conventional treatments are warranted. Although allo-SCT was found to be effective in T-LBL, its role in other forms of TCL is yet to be determined. Innovative strategies remain needed for pts with relapsed disease.</jats:p> </jats:sec> <jats:sec> <jats:title>Disclosures:</jats:title> <jats:p>No relevant conflicts of interest to declare.</jats:p> </jats:sec>
  • Beschreibung: <jats:title>Abstract</jats:title>
    <jats:p>Abstract 4118</jats:p>
    <jats:sec>
    <jats:title>BACKGROUND:</jats:title>
    <jats:p>Despite the advent of novel agents, outcomes of T cell Lymphoma (TCL) with conventional chemotherapy are poor. We have previously reported (Rodriguez J, JCO 2001) encouraging results with autologous stem cell transplantation (ASCT). Others have advocated allogeneic transplants (Allo-SCT). Herein, we report our long-term experience in 196 TCL patients (pts) who had either ASCT (n=119) or Allo-SCT (n=77).</jats:p>
    </jats:sec>
    <jats:sec>
    <jats:title>METHOD and PATIENTS:</jats:title>
    <jats:p>This is a retrospective analysis of TCL pts treated with SCT at our institution between 1986 and 2009. We adopted WHO 2008 classification for TCL and divided pts accordingly into Nodal TCL (N-TCL), extra nodal TCL (EN-TCL), and T cell lymphoblastic Lymphoma (T-LBL). Sixty one pts (31%) had peripheral t-cell not otherwise specified (PTCL), 50 (26%) had anaplastic large cell (ALCL), 19 (10%) angioimmunoblatic (AITL), 34 (17%) EN-TCL, and 32 (16%) had T-LBL. ASCT and Allo-SCT pts were balanced for Ann-Arbor stage, gender distribution and time from initial diagnosis. However, Allo-SCT pts were younger (median age 41 vs. 49 yrs, respectively, (p=0.002), more heavily pretreated (p=0.01), were more likely to have extranodal (p&lt;0.001) or bone marrow involvement (p=0.001), and refractory disease (p=0.01) at the time of transplant.</jats:p>
    </jats:sec>
    <jats:sec>
    <jats:title>RESULTS: A. [ASCT]:</jats:title>
    <jats:p>Most pts (82%)received BEAM-like conditioning. With a median follow-up of 39 months (range, 3–208), the OS and PFS rates were 39% and 30%, respectively. Risk factors for OS and PFS were evaluated among the largest histologic subgroups, i.e., PTCL, ALCL and AITL: among those 94 pts who received ASCT, having a transplant &gt; CR1 (p=0.001), Prognostic Index for TCL(PIT) &gt;0 (p=0.009), IPI&gt;1 (p=0.03), refractory disease (p=0.001) were associated with worse OS and PFS (Figure 1). The 3-year OS and PFS for CR1 pts (n+33) were 90% and 70%, respectively. A subset of pts (n= 11) within the CR1 group received induction chemotherapy with Hyper-CVAD before ASCT. The 3-year OS and PFS rates for these pts were both 100%. We were not able to detect any difference in outcomes between the different histologies studied, including ALK(+) and ALK (−) ALCL. B. [Allo-SCT] Most pts (75%) received myeloablative conditioning. There was a trend for better outcomes for transplants &gt; year 2000. With a median follow-up of 65 months (range, 5–235), the OS and PFS rates were 43% and 30%, respectively. OS and PFS rates for EN-TCL(n=18) were 49% and 36%, respectively. Among the N-TCL (n=33) group, unlike ASCT, most pts (87%) were &gt;CR1. The 3-year OS and PFS rates for these pts were 38% and 23%, respectively. Both IPI and PIT &gt;0 were determinants for worse PFS, whereas IPI &gt;0 and marrow involvement were predictors for worse OS. No plateau however was observed in these pts, unlike those with T-LBL, where a clear plateau of 40 % was observed.</jats:p>
    </jats:sec>
    <jats:sec>
    <jats:title>CONCLUSION:</jats:title>
    <jats:p>This is the largest single institution analysis to investigate the role of SCT for TCL. Our review demonstrates that ASCT can induce long-term remissions in CR1 pts with N-TCL. Prospective studies comparing ASCT in this setting to other conventional treatments are warranted. Although allo-SCT was found to be effective in T-LBL, its role in other forms of TCL is yet to be determined. Innovative strategies remain needed for pts with relapsed disease.</jats:p>
    </jats:sec>
    <jats:sec>
    <jats:title>Disclosures:</jats:title>
    <jats:p>No relevant conflicts of interest to declare.</jats:p>
    </jats:sec>
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