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

Satoshi Yamasaki; Dai Chihara; Sung-Won Kim; Takahito Kawata; Shuichi Mizuta; Hiroatsu Ago; Takaaki Chou; Takahisa Yamane; Hitoji Uchiyama; Tatsuo Oyake; Katsuhiro Miura; Bungo Saito; Hirofumi Taji; Hirohisa Nakamae; Toshihiro Miyamoto; Takahiro Fukuda; Junya Kanda; Yoshiko Atsuta; Ritsuro Suzuki

doi:10.1007/s12185-018-2560-x

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

Int J Hematol. 2019 Feb;109(2):175-186. doi: 10.1007/s12185-018-2560-x. Epub 2018 Nov 14.

Authors

Satoshi Yamasaki¹, Dai Chihara², Sung-Won Kim³, Takahito Kawata⁴, Shuichi Mizuta⁵, Hiroatsu Ago⁶, Takaaki Chou⁷, Takahisa Yamane⁸, Hitoji Uchiyama⁹, Tatsuo Oyake¹⁰, Katsuhiro Miura¹¹, Bungo Saito¹², Hirofumi Taji¹³, Hirohisa Nakamae¹⁴, Toshihiro Miyamoto¹⁵, Takahiro Fukuda³, Junya Kanda⁴, Yoshiko Atsuta¹⁶, Ritsuro Suzuki¹⁷

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. [email protected].
² Medical Oncology Service, Center for Cancer Research, National Cancer Institute, National Institute of Health, Bethesda, MD, USA.
³ Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan.
⁴ Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
⁵ Department of Hematology and Immunology, Kanazawa Medical University, Ishikawa, Japan.
⁶ Department of Hematology and Oncology, Shimane Prefectural Central Hospital, Izumo, Japan.
⁷ Department of Hematology and Oncology, Niigata Cancer Center Hospital, Niigata, Japan.
⁸ Department of Hematology, Osaka City General Hospital, Osaka, Japan.
⁹ Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan.
¹⁰ Division of Hematology and Oncology, Department of Internal Medicine, Iwate Medical University, Morioka, Japan.
¹¹ Department of Hematology and Rheumatology, Center of Hematoloietic Cell Transplantation and Cell Therapy, Nihon University School of Medicine, Tokyo, Japan.
¹² Division of Hematology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan.
¹³ Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital, Nagoya, Japan.
¹⁴ Department of Hematology, Osaka City University Hospital, Osaka, Japan.
¹⁵ Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan.
¹⁶ Department of Healthcare Administration, Nagoya University Graduate School of Medicine and Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan.
¹⁷ Department of Oncology and Hematology, Shimane University Hospital, Izumo, Japan.

PMID: 30430419
DOI: 10.1007/s12185-018-2560-x

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.

Keywords: Angioimmunoblastic T-cell lymphoma; Autologous stem cell transplantation; Peripheral T-cell lymphoma not otherwise specified.

MeSH terms

Adolescent
Adult
Aged
Female
Hematopoietic Stem Cell Transplantation / methods*
Humans
Immunoblastic Lymphadenopathy / mortality
Immunoblastic Lymphadenopathy / therapy
Lymphoma, T-Cell, Peripheral / mortality
Lymphoma, T-Cell, Peripheral / therapy*
Male
Middle Aged
Patient Selection
Retrospective Studies
Risk Factors
Survival Analysis
Time Factors
Transplantation, Autologous