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

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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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Acknowledgements

We thank the patients and clinical staff for their participation in the study. We are very grateful to the Japanese Data Center for Hematopoietic Cell Transplantation for data management and the Clinical Research Institute of Kyushu Medical Hospital, Dr. Hiromi Iwasaki (Kyushu medical center), and Dr. Junji Suzumiya (Shimane University Hospital) for helpful discussions and their editorial support. We also thank Mitchell Arico from Edanz Group (http://www.edanzediting.com/ac) for editing a draft of this manuscript. This work was supported by the Practical Research Project for Allergic Diseases and Immunology (Research Technology of Medical Transplantation) of the Japan Agency for Medical Research and Development (AMED).

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Authors and Affiliations

  1. Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-Ku, Fukuoka, 810-8563, Japan

    Satoshi Yamasaki

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

    Dai Chihara

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

    Sung-Won Kim & Takahiro Fukuda

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

    Takahito Kawata & Junya Kanda

  5. Department of Hematology and Immunology, Kanazawa Medical University, Ishikawa, Japan

    Shuichi Mizuta

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

    Hiroatsu Ago

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

    Takaaki Chou

  8. Department of Hematology, Osaka City General Hospital, Osaka, Japan

    Takahisa Yamane

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

    Hitoji Uchiyama

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

    Tatsuo Oyake

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

    Katsuhiro Miura

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

    Bungo Saito

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

    Hirofumi Taji

  14. Department of Hematology, Osaka City University Hospital, Osaka, Japan

    Hirohisa Nakamae

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

    Toshihiro Miyamoto

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

    Yoshiko Atsuta

  17. Department of Oncology and Hematology, Shimane University Hospital, Izumo, Japan

    Ritsuro Suzuki

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  1. Satoshi Yamasaki
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  2. Dai Chihara
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Correspondence to Satoshi Yamasaki.

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Yamasaki, S., Chihara, D., Kim, SW. et al. Risk factors and timing of autologous stem cell transplantation for patients with peripheral T-cell lymphoma. Int J Hematol 109, 175–186 (2019). https://doi.org/10.1007/s12185-018-2560-x

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