Cancer Res Treat.  2023 Apr;55(2):684-692. 10.4143/crt.2022.1434.

Current Treatment Patterns and the Role of Upfront Autologous Stem Cell Transplantation in Patients with Peripheral T-Cell Lymphoma: A Korean Nationwide, Multicenter Prospective Registry Study (CISL 1404)

• Cho H
• Yoon DH
• Shin DY
• Koh Y
• Yoon SS
• Kim SJ
• Do YR
• Lee GW
• Kwak JY
• Park Y
• Kim MK
• Kang HJ
• Yi JH
• Yoo KH
• Lee WS
• Park BB
• Jo JC
• Eom HS
• Kim HJ
• Jeong SH
• Won YW
• Sohn BS
• Kwon JH
• Suh C
• Kim WS

• KMID: 2541255
• DOI: http://doi.org/10.4143/crt.2022.1434

Abstract

Purpose
We conducted a nationwide, multicenter, prospective registry study for newly diagnosed patients with peripheral T-cell lymphoma (PTCL) to better define the clinical characteristics, treatment patterns, survival outcomes, and the role of upfront autologous stem cell transplantation (ASCT) in these patients.
Materials and Methods
Patients with PTCL receiving chemotherapy with curative intent were registered and prospectively monitored. All patients were pathologically diagnosed with PTCL.
Results
A total of 191 patients with PTCL were enrolled in this prospective registry study. PTCL, not otherwise specified (PTCL-NOS) was the most common pathologic subtype (n=80, 41.9%), followed by angioimmunoblastic T-cell lymphoma (AITL) (n=60, 31.4%). With a median follow-up duration of 3.9 years, the 3-year progression-free survival (PFS) and overall survival (OS) rates were 39.5% and 60.4%, respectively. The role of upfront ASCT was evaluated in patients who were considered transplant-eligible (n=59). ASCT was performed as an upfront consolidative treatment in 32 (54.2%) of these patients. There were no significant differences in PFS and OS between the ASCT and non-ASCT groups for all patients (n=59) and for patients with PTCL-NOS (n=26). However, in patients with AITL, the ASCT group was associated with significantly better PFS than the non-ASCT group, although there was no significant difference in OS.
Conclusion
The current study demonstrated that the survival outcomes with the current treatment options remain poor for patients with PTCL-NOS. Upfront ASCT may provide a survival benefit for patients with AITL, but not PTCL-NOS.

Keyword

Peripheral T-cell lymphoma; Treatment pattern; Autologous stem cell transplantation

Figure

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  Fig. 1 Progression-free survival (A) and overall survival (B) of all patients (n=191). Progression-free survival (C) and overall survival (D) according to the five most common subtypes of PTCL (PTCL-NOS, AITL, ALK+ ALCL, ALK− ALCL, and MEITL) (n=184). AITL, angioimmunoblastic T-cell lymphoma; ALCL, anaplastic large cell lymphoma; ALK, anaplastic lymphoma kinase; MEITL, monomorphic epitheliotropic intestinal T-cell lymphoma; PTCL-NOS, peripheral T-cell lymphoma not otherwise specified.

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  Fig. 2 Progression-free survival (A) and overall survival (B) according to upfront autologous stem cell transplantation (ASCT) in transplant-eligible patients.

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  Fig. 3 Progression-free survival according to upfront autologous stem cell transplantation (ASCT) in patients who achieved complete remission (A) and partial remission (B) from first-line systemic chemotherapy. Progression-free survival according to upfront ASCT in patients with limited-stage disease (C), advanced-stage disease (D), low International Prognostic Index (IPI) score (E) (low or low-intermediate risk group), high IPI score (high-intermediate or high-risk group) (F), low Prognostic Index for peripheral T-cell lymphoma–unspecified (PIT) score (group 1 or 2) (G), high PIT score (group 3 or 4) (H).

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  Fig. 4 Progression-free survival (A) and overall survival (B) according to upfront autologous stem cell transplantation (ASCT) in peripheral T-cell lymphoma not otherwise specified patients. Progression-free survival (C) and overall survival (D) according to upfront ASCT in angioimmunoblastic T-cell lymphoma patients.

Reference

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