International Journal of Hematology

DOI: 10.1007/s12185-018-2560-x Pages: 1-12

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

1. National Hospital Organization Kyushu Medical Center, Department of Hematology and Clinical Research Institute

2. National Cancer Institute, National Institute of Health, Medical Oncology Service, Center for Cancer Research

3. National Cancer Center Hospital, Division of Hematopoietic Stem Cell Transplantation

4. Kyoto University, Department of Hematology and Oncology, Graduate School of Medicine

5. Kanazawa Medical University, Department of Hematology and Immunology

6. Shimane Prefectural Central Hospital, Department of Hematology and Oncology

7. Niigata Cancer Center Hospital, Department of Hematology and Oncology

8. Osaka City General Hospital, Department of Hematology

9. Japanese Red Cross Kyoto Daiichi Hospital, Department of Hematology

10. Iwate Medical University, Division of Hematology and Oncology, Department of Internal Medicine

11. Nihon University School of Medicine, Department of Hematology and Rheumatology, Center of Hematoloietic Cell Transplantation and Cell Therapy

12. Showa University School of Medicine, Division of Hematology, Department of Medicine

13. Aichi Cancer Center Hospital, Department of Hematology and Cell Therapy

14. Osaka City University Hospital, Department of Hematology

15. Kyushu University Hospital, Hematology, Oncology and Cardiovascular Medicine

16. Nagoya University Graduate School of Medicine and Japanese Data Center for Hematopoietic Cell Transplantation, Department of Healthcare Administration

17. Shimane University Hospital, Department of Oncology and Hematology

Correspondence to:
Satoshi Yamasaki
Tel: +81-92-852-0700
Email: yamas009@gmail.com

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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.

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