Intensified Chemo-immunotherapy with or Without Stem Cell Transplantation in Newly Diagnosed Patients with Peripheral T-cell Lymphoma

Overview

Journal Leukemia

Specialties Hematology
Oncology

Date 2014 Mar 26

PMID 24662801

Citations 25

Authors

P Corradini

U Vitolo

A Rambaldi

R Miceli

F Patriarca

A Gallamini

A Olivieri

F Benedetti

G Todeschini

G Rossi

F Salvi

B Bruno

L Baldini

A Ferreri

C Patti

C Tarella

S Pileri

A Dodero

Affiliations

Soon will be listed here.

Abstract

Peripheral T-cell lymphomas (PTCLs) receiving conventional treatment have a poor clinical outcome. We conducted a phase II study to evaluate the feasibility and efficacy of chemo-immunotherapy in young (⩽60 years old, Clin A study) and elderly (>60 and < or =75 years old, Clin B study) patients with newly diagnosed PTCL. Clin A patients (n=61) received two courses of CHOP (cyclophosphamide, adriamycin, vincristine, prednisone)-21 with alemtuzumab (AL, 30 mg) followed by two courses of high-dose chemotherapy. On the basis of donor availability, patients in response received allogeneic (allo) or autologous (auto) stem cell transplantation (SCT). Clin B patients (n=25) received six courses of CHOP-21 and AL (10 mg). Clin A responding patients were 38 of 61 (62%) and received alloSCT (n=23) or autoSCT (n=14); one complete remission (CR) patient was not transplanted. At a median follow-up of 40 months, the 4-year overall survival (OS), progression-free survival (PFS) and disease-free survival (DFS) rates were 49, 44 and 65%, respectively. In Clin B study, the response rate was 72%. At a median follow-up of 48 months, the 4-year OS, PFS and DFS rates were 31, 26 and 44%, respectively. In conclusion, front-line alloSCT or autoSCT is effective in prolonging DFS in young patients; AL in elderly improved response with no survival benefit.

Citing Articles

Optimized BEAC conditioning regimen improves clinical outcomes of autologous hematopoietic stem cell transplantation in non-Hodgkin lymphomas.

Zhou S, Rao J, Ma X, Zeng Y, Xiang X, Li J Int J Hematol. 2024; 120(1):96-105.

PMID: 38587693 PMC: 11226560. DOI: 10.1007/s12185-024-03755-7.

Innovations in Antibody-Drug Conjugate (ADC) in the Treatment of Lymphoma.

Al Sbihi A, Alasfour M, Pongas G Cancers (Basel). 2024; 16(4).

PMID: 38398219 PMC: 10887180. DOI: 10.3390/cancers16040827.

Autologous Stem Cell Transplant in Hodgkin's and Non-Hodgkin's Lymphoma, Multiple Myeloma, and AL Amyloidosis.

Alnasser S, Alharbi K, Almutairy A, Almutairi S, Alolayan A Cells. 2023; 12(24).

PMID: 38132175 PMC: 10741865. DOI: 10.3390/cells12242855.

Real-world data of long-term survival in patients with T-cell lymphoma who underwent stem cell transplantation.

Baek D, Moon J, Lee J, Kang K, Lee H, Eom H Blood Cancer J. 2023; 13(1):95.

PMID: 37365207 PMC: 10293168. DOI: 10.1038/s41408-023-00868-w.

Peripheral T-Cell Lymphomas: Therapeutic Approaches.

Sibon D Cancers (Basel). 2022; 14(9).

PMID: 35565460 PMC: 9104854. DOI: 10.3390/cancers14092332.

References

Gallamini A, Zaja F, Patti C, Billio A, Specchia M, Tucci A . Alemtuzumab (Campath-1H) and CHOP chemotherapy as first-line treatment of peripheral T-cell lymphoma: results of a GITIL (Gruppo Italiano Terapie Innovative nei Linfomi) prospective multicenter trial. Blood. 2007; 110(7):2316-23. DOI: 10.1182/blood-2007-02-074641. View

Schmitz N, Trumper L, Ziepert M, Nickelsen M, Ho A, Metzner B . Treatment and prognosis of mature T-cell and NK-cell lymphoma: an analysis of patients with T-cell lymphoma treated in studies of the German High-Grade Non-Hodgkin Lymphoma Study Group. Blood. 2010; 116(18):3418-25. DOI: 10.1182/blood-2010-02-270785. View

Rodig S, Abramson J, Pinkus G, Treon S, Dorfman D, Dong H . Heterogeneous CD52 expression among hematologic neoplasms: implications for the use of alemtuzumab (CAMPATH-1H). Clin Cancer Res. 2006; 12(23):7174-9. DOI: 10.1158/1078-0432.CCR-06-1275. View

Rodriguez J, Conde E, Gutierrez A, Arranz R, Leon A, Marin J . Frontline autologous stem cell transplantation in high-risk peripheral T-cell lymphoma: a prospective study from The Gel-Tamo Study Group. Eur J Haematol. 2007; 79(1):32-8. DOI: 10.1111/j.1600-0609.2007.00856.x. View

Kim S, Yoon D, Kang H, Kim J, Park S, Kim H . Bortezomib in combination with CHOP as first-line treatment for patients with stage III/IV peripheral T-cell lymphomas: a multicentre, single-arm, phase 2 trial. Eur J Cancer. 2012; 48(17):3223-31. DOI: 10.1016/j.ejca.2012.06.003. View

Savage K, Chhanabhai M, Gascoyne R, Connors J . Characterization of peripheral T-cell lymphomas in a single North American institution by the WHO classification. Ann Oncol. 2004; 15(10):1467-75. DOI: 10.1093/annonc/mdh392. View

Damaj G, Gressin R, Bouabdallah K, Cartron G, Choufi B, Gyan E . Results from a prospective, open-label, phase II trial of bendamustine in refractory or relapsed T-cell lymphomas: the BENTLY trial. J Clin Oncol. 2012; 31(1):104-10. DOI: 10.1200/JCO.2012.43.7285. View

Lemonnier F, Couronne L, Parrens M, Jais J, Travert M, Lamant L . Recurrent TET2 mutations in peripheral T-cell lymphomas correlate with TFH-like features and adverse clinical parameters. Blood. 2012; 120(7):1466-9. DOI: 10.1182/blood-2012-02-408542. View

Dodero A, Spina F, Narni F, Patriarca F, Cavattoni I, Benedetti F . Allogeneic transplantation following a reduced-intensity conditioning regimen in relapsed/refractory peripheral T-cell lymphomas: long-term remissions and response to donor lymphocyte infusions support the role of a graft-versus-lymphoma effect. Leukemia. 2011; 26(3):520-6. DOI: 10.1038/leu.2011.240. View

10.

Geissinger E, Bonzheim I, Roth S, Rosenwald A, Muller-Hermelink H, Rudiger T . CD52 expression in peripheral T-cell lymphomas determined by combined immunophenotyping using tumor cell specific T-cell receptor antibodies. Leuk Lymphoma. 2009; 50(6):1010-6. DOI: 10.1080/10428190902926981. View

11.

Kluin-Nelemans H, van Marwijk Kooy M, Lugtenburg P, van Putten W, Luten M, Oudejans J . Intensified alemtuzumab-CHOP therapy for peripheral T-cell lymphoma. Ann Oncol. 2011; 22(7):1595-1600. DOI: 10.1093/annonc/mdq635. View

12.

Corradini P, Dodero A, Zallio F, Caracciolo D, Casini M, Bregni M . Graft-versus-lymphoma effect in relapsed peripheral T-cell non-Hodgkin's lymphomas after reduced-intensity conditioning followed by allogeneic transplantation of hematopoietic cells. J Clin Oncol. 2004; 22(11):2172-6. DOI: 10.1200/JCO.2004.12.050. View

13.

Mercadal S, Briones J, Xicoy B, Pedro C, Escoda L, Estany C . Intensive chemotherapy (high-dose CHOP/ESHAP regimen) followed by autologous stem-cell transplantation in previously untreated patients with peripheral T-cell lymphoma. Ann Oncol. 2008; 19(5):958-63. DOI: 10.1093/annonc/mdn022. View

14.

Kanakry J, Kasamon Y, Gocke C, Tsai H, Davis-Sproul J, Ghosh N . Outcomes of related donor HLA-identical or HLA-haploidentical allogeneic blood or marrow transplantation for peripheral T cell lymphoma. Biol Blood Marrow Transplant. 2013; 19(4):602-6. PMC: 4020434. DOI: 10.1016/j.bbmt.2013.01.006. View

15.

OConnor O, Pro B, Pinter-Brown L, Bartlett N, Popplewell L, Coiffier B . Pralatrexate in patients with relapsed or refractory peripheral T-cell lymphoma: results from the pivotal PROPEL study. J Clin Oncol. 2011; 29(9):1182-9. PMC: 3083873. DOI: 10.1200/JCO.2010.29.9024. View

16.

Le Gouill S, Milpied N, Buzyn A, Peffault de Latour R, Vernant J, Mohty M . Graft-versus-lymphoma effect for aggressive T-cell lymphomas in adults: a study by the Société Francaise de Greffe de Moëlle et de Thérapie Cellulaire. J Clin Oncol. 2008; 26(14):2264-71. DOI: 10.1200/JCO.2007.14.1366. View

17.

Simon R . Optimal two-stage designs for phase II clinical trials. Control Clin Trials. 1989; 10(1):1-10. DOI: 10.1016/0197-2456(89)90015-9. View

18.

Foss F, Zinzani P, Vose J, Gascoyne R, Rosen S, Tobinai K . Peripheral T-cell lymphoma. Blood. 2011; 117(25):6756-67. DOI: 10.1182/blood-2010-05-231548. View

19.

Cheson B, Horning S, Coiffier B, Shipp M, Fisher R, Connors J . Report of an international workshop to standardize response criteria for non-Hodgkin's lymphomas. NCI Sponsored International Working Group. J Clin Oncol. 1999; 17(4):1244. DOI: 10.1200/JCO.1999.17.4.1244. View

20.

Coiffier B, Pro B, Prince H, Foss F, Sokol L, Greenwood M . Results from a pivotal, open-label, phase II study of romidepsin in relapsed or refractory peripheral T-cell lymphoma after prior systemic therapy. J Clin Oncol. 2012; 30(6):631-6. DOI: 10.1200/JCO.2011.37.4223. View