Upfront Autologuos Stem-Cell Transplantation in Peripheral T-Cell Lymphoma: NLG-T-01.
(2012) In Journal of Clinical Oncology 30(25). p.3093-3099- Abstract
- PURPOSE:
Systemic peripheral T-cell lymphomas (PTCLs) respond poorly to conventional therapy. To evaluate the efficacy of a dose-dense approach consolidated by upfront high-dose chemotherapy (HDT) and autologous stem-cell transplantation (ASCT) in PTCL, the Nordic Lymphoma Group (NLG) conducted a large prospective phase II study in untreated systemic PTCL. This is the final report, with a 5-year median follow-up, of the NLG-T-01 study.
PATIENTS AND METHODS:
Treatment-naive patients with PTCL age 18 to 67 years (median, 57 years) were included. Anaplastic lymphoma kinase (ALK) -positive anaplastic large-cell lymphoma (ALCL) was excluded. An induction regimen of six cycles of biweekly CHOEP... (More) - PURPOSE:
Systemic peripheral T-cell lymphomas (PTCLs) respond poorly to conventional therapy. To evaluate the efficacy of a dose-dense approach consolidated by upfront high-dose chemotherapy (HDT) and autologous stem-cell transplantation (ASCT) in PTCL, the Nordic Lymphoma Group (NLG) conducted a large prospective phase II study in untreated systemic PTCL. This is the final report, with a 5-year median follow-up, of the NLG-T-01 study.
PATIENTS AND METHODS:
Treatment-naive patients with PTCL age 18 to 67 years (median, 57 years) were included. Anaplastic lymphoma kinase (ALK) -positive anaplastic large-cell lymphoma (ALCL) was excluded. An induction regimen of six cycles of biweekly CHOEP (cyclophosphamide, doxorubicin, vincristine, etoposide, and prednisone) was administered (in patients age > 60 years, etoposide was omitted). If in complete or partial remission, patients proceeded to consolidation with HDT/ASCT.
Results:
Of 166 enrolled patients, 160 had histopathologically confirmed PTCL. The majority presented with advanced-stage disease, B symptoms, and elevated serum lactate dehydrogenase. A total of 115 underwent HDT/ASCT, with 90 in complete remission at 3 months post-transplantation. Early failures occurred in 26%. Treatment-related mortality was 4%. At 60.5 months of median follow-up, 83 patients were alive. Consolidated 5-year overall and progression-free survival (PFS) were 51% (95% CI, 43% to 59%) and 44% (95% CI, 36% to 52%), respectively. Best results were obtained in ALK-negative ALCL.
CONCLUSION:
Dose-dense induction followed by HDT/ASCT was well tolerated and led to long-term PFS in 44% of treatment-naive patients with PTCL. This represents an encouraging outcome, particularly considering the high median age and adverse risk profile of the study population. Therefore, dose-dense induction and HDT/ASCT are a rational upfront strategy in transplantation-eligible patients with PTCL. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/3047851
- author
- organization
- publishing date
- 2012
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Journal of Clinical Oncology
- volume
- 30
- issue
- 25
- pages
- 3093 - 3099
- publisher
- American Society of Clinical Oncology
- external identifiers
-
- wos:000308558800015
- pmid:22851556
- scopus:84865712593
- pmid:22851556
- ISSN
- 1527-7755
- DOI
- 10.1200/JCO.2011.40.2719
- language
- English
- LU publication?
- yes
- id
- 3e875a60-a680-4dcb-8883-21127fcd1e4f (old id 3047851)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/22851556?dopt=Abstract
- date added to LUP
- 2016-04-01 10:37:15
- date last changed
- 2022-04-27 23:37:40
@article{3e875a60-a680-4dcb-8883-21127fcd1e4f, abstract = {{PURPOSE:<br/><br> Systemic peripheral T-cell lymphomas (PTCLs) respond poorly to conventional therapy. To evaluate the efficacy of a dose-dense approach consolidated by upfront high-dose chemotherapy (HDT) and autologous stem-cell transplantation (ASCT) in PTCL, the Nordic Lymphoma Group (NLG) conducted a large prospective phase II study in untreated systemic PTCL. This is the final report, with a 5-year median follow-up, of the NLG-T-01 study. <br/><br> <br/><br> PATIENTS AND METHODS:<br/><br> Treatment-naive patients with PTCL age 18 to 67 years (median, 57 years) were included. Anaplastic lymphoma kinase (ALK) -positive anaplastic large-cell lymphoma (ALCL) was excluded. An induction regimen of six cycles of biweekly CHOEP (cyclophosphamide, doxorubicin, vincristine, etoposide, and prednisone) was administered (in patients age > 60 years, etoposide was omitted). If in complete or partial remission, patients proceeded to consolidation with HDT/ASCT.<br/><br> <br/><br> Results:<br/><br> Of 166 enrolled patients, 160 had histopathologically confirmed PTCL. The majority presented with advanced-stage disease, B symptoms, and elevated serum lactate dehydrogenase. A total of 115 underwent HDT/ASCT, with 90 in complete remission at 3 months post-transplantation. Early failures occurred in 26%. Treatment-related mortality was 4%. At 60.5 months of median follow-up, 83 patients were alive. Consolidated 5-year overall and progression-free survival (PFS) were 51% (95% CI, 43% to 59%) and 44% (95% CI, 36% to 52%), respectively. Best results were obtained in ALK-negative ALCL. <br/><br> <br/><br> CONCLUSION:<br/><br> Dose-dense induction followed by HDT/ASCT was well tolerated and led to long-term PFS in 44% of treatment-naive patients with PTCL. This represents an encouraging outcome, particularly considering the high median age and adverse risk profile of the study population. Therefore, dose-dense induction and HDT/ASCT are a rational upfront strategy in transplantation-eligible patients with PTCL.}}, author = {{d'Amore, Francesco and Relander, Thomas and Lauritzsen, Grete F and Jantunen, Esa and Hagberg, Hans and Anderson, Harald and Holte, Harald and Osterborg, Anders and Merup, Mats and Brown, Peter and Kuittinen, Outi and Erlanson, Martin and Ostenstad, Bjørn and Fagerli, Unn-Merete and Gadeberg, Ole V and Sundström, Christer and Delabie, Jan and Ralfkiaer, Elisabeth and Vornanen, Martine and Toldbod, Helle E}}, issn = {{1527-7755}}, language = {{eng}}, number = {{25}}, pages = {{3093--3099}}, publisher = {{American Society of Clinical Oncology}}, series = {{Journal of Clinical Oncology}}, title = {{Upfront Autologuos Stem-Cell Transplantation in Peripheral T-Cell Lymphoma: NLG-T-01.}}, url = {{http://dx.doi.org/10.1200/JCO.2011.40.2719}}, doi = {{10.1200/JCO.2011.40.2719}}, volume = {{30}}, year = {{2012}}, }