TY - JOUR
T1 - The role of autologous stem cell transplantation in patients with nodal peripheral T-cell lymphomas in first complete remission
T2 - Report from COMPLETE, a prospective, multicenter cohort study
AU - for the COMPLETE Investigators
AU - Park, Steven I.
AU - Horwitz, Steven M.
AU - Foss, Francine M.
AU - Pinter-Brown, Lauren C.
AU - Carson, Kenneth R.
AU - Rosen, Steven T.
AU - Pro, Barbara
AU - Hsi, Eric D.
AU - Federico, Massimo
AU - Gisselbrecht, Christian
AU - Schwartz, Marc
AU - Bellm, Lisa A.
AU - Acosta, Mark
AU - Advani, Ranjana H.
AU - Feldman, Tatyana
AU - Lechowicz, Mary Jo
AU - Smith, Sonali M.
AU - Lansigan, Frederick
AU - Tulpule, Anil
AU - Craig, Michael D.
AU - Greer, John P.
AU - Kahl, Brad S.
AU - Leach, Joseph W.
AU - Morganstein, Neil
AU - Casulo, Carla
AU - Shustov, Andrei R.
N1 - Publisher Copyright:
© 2019 American Cancer Society
PY - 2019/5/1
Y1 - 2019/5/1
N2 - Background: The role of autologous stem cell transplantation (ASCT) in the first complete remission (CR1) of peripheral T-cell lymphomas (PTCLs) is not well defined. This study analyzed the impact of ASCT on the clinical outcomes of patients with newly diagnosed PTCL in CR1. Methods: Patients with newly diagnosed, histologically confirmed, aggressive PTCL were prospectively enrolled into the Comprehensive Oncology Measures for Peripheral T-Cell Lymphoma Treatment (COMPLETE) study, and those in CR1 were included in this analysis. Results: Two hundred thirteen patients with PTCL achieved CR1, and 119 patients with nodal PTCL, defined as anaplastic lymphoma kinase–negative anaplastic large cell lymphoma, angioimmunoblastic T-cell lymphoma (AITL), or PTCL not otherwise specified, were identified. Eighty-three patients did not undergo ASCT, whereas 36 underwent consolidative ASCT in CR1. At the median follow-up of 2.8 years, the median overall survival was not reached for the entire cohort of patients who underwent ASCT, whereas it was 57.6 months for those not receiving ASCT (P =.06). ASCT was associated with superior survival for patients with advanced-stage disease or intermediate-to-high International Prognostic Index scores. ASCT significantly improved overall and progression-free survival for patients with AITL but not for patients with other PTCL subtypes. In a multivariable analysis, ASCT was independently associated with improved survival (hazard ratio, 0.37; 95% confidence interval, 0.15-0.89). Conclusions: This is the first large prospective cohort study directly comparing the survival outcomes of patients with nodal PTCL in CR1 with or without consolidative ASCT. ASCT may provide a benefit in specific clinical scenarios, but the broader applicability of this strategy should be determined in prospective, randomized trials. These results provide a platform for designing future studies of previously untreated PTCL.
AB - Background: The role of autologous stem cell transplantation (ASCT) in the first complete remission (CR1) of peripheral T-cell lymphomas (PTCLs) is not well defined. This study analyzed the impact of ASCT on the clinical outcomes of patients with newly diagnosed PTCL in CR1. Methods: Patients with newly diagnosed, histologically confirmed, aggressive PTCL were prospectively enrolled into the Comprehensive Oncology Measures for Peripheral T-Cell Lymphoma Treatment (COMPLETE) study, and those in CR1 were included in this analysis. Results: Two hundred thirteen patients with PTCL achieved CR1, and 119 patients with nodal PTCL, defined as anaplastic lymphoma kinase–negative anaplastic large cell lymphoma, angioimmunoblastic T-cell lymphoma (AITL), or PTCL not otherwise specified, were identified. Eighty-three patients did not undergo ASCT, whereas 36 underwent consolidative ASCT in CR1. At the median follow-up of 2.8 years, the median overall survival was not reached for the entire cohort of patients who underwent ASCT, whereas it was 57.6 months for those not receiving ASCT (P =.06). ASCT was associated with superior survival for patients with advanced-stage disease or intermediate-to-high International Prognostic Index scores. ASCT significantly improved overall and progression-free survival for patients with AITL but not for patients with other PTCL subtypes. In a multivariable analysis, ASCT was independently associated with improved survival (hazard ratio, 0.37; 95% confidence interval, 0.15-0.89). Conclusions: This is the first large prospective cohort study directly comparing the survival outcomes of patients with nodal PTCL in CR1 with or without consolidative ASCT. ASCT may provide a benefit in specific clinical scenarios, but the broader applicability of this strategy should be determined in prospective, randomized trials. These results provide a platform for designing future studies of previously untreated PTCL.
KW - anaplastic lymphoma kinase (ALK)–negative anaplastic large cell lymphoma
KW - angioimmunoblastic T-cell lymphoma (AITL)
KW - autologous stem cell transplant
KW - first complete remission
KW - nodal peripheral T-cell lymphoma
KW - peripheral T-cell lymphoma (PTCL) not otherwise specified (NOS)
UR - http://www.scopus.com/inward/record.url?scp=85060762774&partnerID=8YFLogxK
U2 - 10.1002/cncr.31861
DO - 10.1002/cncr.31861
M3 - Article
C2 - 30694529
AN - SCOPUS:85060762774
SN - 0008-543X
VL - 125
SP - 1507
EP - 1517
JO - Cancer
JF - Cancer
IS - 9
ER -