First-line therapy for T cell lymphomas: a retrospective population-based analysis of 906 T cell lymphoma patients
Jazyk angličtina Země Německo Médium print-electronic
Typ dokumentu časopisecké články
Grantová podpora
AZV CR 16-31092A
Ministry of Education and Youth of the Czech Republic
PubMed
31065733
DOI
10.1007/s00277-019-03694-y
PII: 10.1007/s00277-019-03694-y
Knihovny.cz E-zdroje
- Klíčová slova
- Auto-SCT, Etoposide, Prognosis, T cell lymphoma,
- MeSH
- analýza přežití MeSH
- autologní transplantace MeSH
- cyklofosfamid terapeutické užití MeSH
- dospělí MeSH
- doxorubicin terapeutické užití MeSH
- etoposid terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- periferní T-buněčný lymfom diagnóza mortalita patologie terapie MeSH
- prednisolon terapeutické užití MeSH
- prednison terapeutické užití MeSH
- prognóza MeSH
- progrese nemoci MeSH
- protokoly protinádorové kombinované chemoterapie terapeutické užití MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- staging nádorů MeSH
- transplantace hematopoetických kmenových buněk * MeSH
- vinkristin terapeutické užití MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- cyklofosfamid MeSH
- doxorubicin MeSH
- etoposid MeSH
- prednisolon MeSH
- prednison MeSH
- vinkristin MeSH
Peripheral T cell lymphomas (PTLs) have a globally poor prognosis. The CHOP regimen shows insufficient efficacy; first-line consolidation with autologous stem cell transplantation (auto-SCT) is a promising strategy but has never been confirmed by randomized data. We analyzed retrospectively 906 patients diagnosed with PTL between 1999 and 2015. Chemotherapy was given to 862 patients, and 412 of them were < 60 years. In this subset, we compared induction with CHOP (n = 113) vs. CHOEP (n = 68) and tested auto-SCT (n = 79) vs. no SCT (n = 73) in the intent-to-treat analysis. The median age of the whole cohort at diagnosis was 60 years (range; 18-91); the median follow-up was 4.3 years (range; 0.1-17.8). A shorter overall survival (OS) was associated with the male gender, age ≥ 60 years, stage III/IV, performance status ≥ 2, bulky tumor ≥ 10 cm, and elevated LDH. CHOEP induction showed a better 5-year PFS (25.0% vs. 32.9%; p.001), and 5-year OS (65.6% vs. 47.6%; p.008) than CHOP. Auto-SCT compared to no SCT brought a 5-year OS of 49.2% vs. 59.5% (p.187). Auto-SCT did not influence the OS in low-risk or low-intermediate risk PTLs. The high-intermediate and high-risk IPIs displayed a worse 5-year OS in auto-SCT arm (17.7% vs.46.2%; p.049); however, 73.9% of the patients never received planned auto-SCT. Our population-based analysis showed the superiority of CHOEP over CHOP in first-line treatment. We confirm the 5-year OS of around 50% in PTLs undergoing auto-SCT. However, the intended auto-SCT could not be given in 73.9% of the high-risk PTLs.
3rd Faculty of Medicine Charles University Prague Prague Czech Republic
Department of Clinical Hematology Teaching Hospital Ostrava Ostrava Czech Republic
Department of Hematology University Hospital Olomouc Olomouc Czech Republic
Department of Oncology Hospital Ceske Budejovice Ceske Budejovice Czech Republic
Institute of Biostatistics and Analyses Faculty of Medicine Masaryk University Brno Czech Republic
Internal Clinic of Haematology University Hospital Kralovske Vinohrady Prague Czech Republic
Citace poskytuje Crossref.org
