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Annals of Hematology

, Volume 98, Issue 8, pp 1961–1972 | Cite as

First-line therapy for T cell lymphomas: a retrospective population-based analysis of 906 T cell lymphoma patients

  • Andrea JanikovaEmail author
  • Renata Chloupkova
  • Vit Campr
  • Pavel Klener
  • Jitka Hamouzova
  • David Belada
  • Vit Prochazka
  • Robert Pytlik
  • Jan Pirnos
  • Juraj Duras
  • Heidi Mocikova
  • Zbynek Bortlicek
  • Natasa Kopalova
  • Jiri Mayer
  • Marek Trneny
Original Article

Abstract

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.

Keywords

T cell lymphoma Auto-SCT Etoposide Prognosis 

Notes

Funding information

This work was supported by research grants from the Ministry of Education and Youth of the Czech Republic AZV CR 16-31092A. On behalf of CLSG.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Andrea Janikova
    • 1
    Email author
  • Renata Chloupkova
    • 2
  • Vit Campr
    • 3
  • Pavel Klener
    • 4
  • Jitka Hamouzova
    • 4
  • David Belada
    • 5
  • Vit Prochazka
    • 6
  • Robert Pytlik
    • 4
  • Jan Pirnos
    • 7
  • Juraj Duras
    • 8
  • Heidi Mocikova
    • 9
    • 10
  • Zbynek Bortlicek
    • 2
  • Natasa Kopalova
    • 1
  • Jiri Mayer
    • 1
  • Marek Trneny
    • 4
  1. 1.Department of Internal Medicine–Hematology and OncologyMasaryk University and University Hospital BrnoBrnoCzech Republic
  2. 2.Institute of Biostatistics and AnalysesFaculty of Medicine Masaryk UniversityBrnoCzech Republic
  3. 3.Department of Pathology and Molecular Medicine, 2nd Faculty of MedicineCharles University and Faculty Hospital in MotolPragueCzech Republic
  4. 4.1st Department of Medicine, First Medical FacultyCharles University and General University HospitalPragueCzech Republic
  5. 5.4th Department of Internal Medicine–HematologyCharles University Hospital and Faculty of MedicineHradec KrálovéCzech Republic
  6. 6.Department of HematologyUniversity Hospital OlomoucOlomoucCzech Republic
  7. 7.Department of OncologyHospital Ceske BudejoviceCeske BudejoviceCzech Republic
  8. 8.Department of Clinical HematologyTeaching Hospital OstravaOstravaCzech Republic
  9. 9.Internal Clinic of HaematologyUniversity Hospital Kralovske VinohradyPragueCzech Republic
  10. 10.3rd Faculty of MedicineCharles University in PraguePragueCzech Republic

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