Risk factors and timing of autologous stem cell transplantation for patients with peripheral T-cell lymphoma
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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.
KeywordsAutologous stem cell transplantation Peripheral T-cell lymphoma not otherwise specified Angioimmunoblastic T-cell lymphoma
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).
There are no funding/financial sources.
Compliance with ethical standards
Conflict of interest
The authors have nothing to disclose.
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