Publication details

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

Authors

JANÍKOVÁ Andrea CHLOUPKOVÁ Renata CAMPR Vit KLENER Pavel HAMOUZOVA Jitka BELADA David PROCHAZKA Vit PYTLIK Robert PIRNOS Jan DURAS Juraj MOCIKOVA Heidi BORTLÍČEK Zbyněk KOPALOVA Natasa MAYER Jiří TRNENY Marek

Year of publication 2019
Type Article in Periodical
Magazine / Source Annals of hematology
MU Faculty or unit

Faculty of Medicine

Citation
Web http://dx.doi.org/10.1007/s00277-019-03694-y
Doi http://dx.doi.org/10.1007/s00277-019-03694-y
Keywords T cell lymphoma; Auto-SCT; Etoposide; Prognosis
Description 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 <60years. 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 60years (range; 18-91); the median follow-up was 4.3years (range; 0.1-17.8). A shorter overall survival (OS) was associated with the male gender, age >= 60years, stage III/IV, performance status >= 2, bulky tumor >= 10cm, 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.