First-line therapy for T cell lymphomas: a retrospective population-based analysis of 906 T cell lymphoma patients
Language English Country Germany Media print-electronic
Document type Journal Article
Grant support
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-resources
- Keywords
- Auto-SCT, Etoposide, Prognosis, T cell lymphoma,
- MeSH
- Survival Analysis MeSH
- Transplantation, Autologous MeSH
- Cyclophosphamide therapeutic use MeSH
- Adult MeSH
- Doxorubicin therapeutic use MeSH
- Etoposide therapeutic use MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Lymphoma, T-Cell, Peripheral diagnosis mortality pathology therapy MeSH
- Prednisolone therapeutic use MeSH
- Prednisone therapeutic use MeSH
- Prognosis MeSH
- Disease Progression MeSH
- Antineoplastic Combined Chemotherapy Protocols therapeutic use MeSH
- Retrospective Studies MeSH
- Risk Factors MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Neoplasm Staging MeSH
- Hematopoietic Stem Cell Transplantation * MeSH
- Vincristine therapeutic use MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Names of Substances
- Cyclophosphamide MeSH
- Doxorubicin MeSH
- Etoposide MeSH
- Prednisolone MeSH
- Prednisone MeSH
- Vincristine 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
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