962P - Clinical outcome of upfront high dose chemotherapy plus total body irradiation with autologous hematopoietic stem cell transplantation in patients...

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Lymphomas
Surgery and/or Radiotherapy of Cancer
Presenter Chi Hoon Maeng
Citation Annals of Oncology (2014) 25 (suppl_4): iv327-iv339. 10.1093/annonc/mdu339
Authors C.H. Maeng1, S.J. Kim2, E. Um3, H.A. Jung2
  • 1Hematology-oncology, Kyung Hee University Hospital, 130-872 - SEOUL/KR
  • 2Hematology-oncology, Samsung Medical Center, SEOUL/KR
  • 3Hematology-oncology, Kyung Hee University Hospital, SEOUL/KR

Abstract

Aim

T-cell lymphoma is characterized by aggressiveness and poor response to conventional chemotherapy. Athough high-dose chemotherapy plus total body irradiation with autologous stem cell transplantation (HD TBI-ASCT) has been introduced to improve clinical outcomes, significant benefit has not been established yet. Furthermore, the role of TBI in this setting is not proven either. We report data of upfront HD TBI-ASCT for patients associated with T-cell lymphoma.

Methods

We collected clinical data of patients who were treated with upfront HD TBI-ASCT for T-cell lymphoma from January 2004 to December 2013 at Samsung Medical Center, Korea. Total 42 patients were analyzed retrospectively. All patients received etoposide and cyclophosphamide plus TBI (900 cGy for 3 days) as conditioning regimen. The clinical data includes age, sex, histological subtypes, IPI score, types of induction chemotherapy and response, pre-ASCT status, recurrence or death.

Results

Most common histological subtype was natural killer/T-cell lymphoma, nasal type. Median hospitalized period was 17 days. Median recovery time of neutrophil and platelet was 10 and 11 days, respectively. 5-year survival rate was 57.5%. Median relapse-free survival of the patients was 2.1 years and median overall survival was 2.2 years suggesting very aggressive and refractory disease after relapse. Initial complete response to induction chemotherapy was related to better OS (not reached vs 6.0 months) (p = 0.009) even if RFS failed to show statistical significant difference (p = 0.081). Pre-ASCT PET response (CR vs non-CR) showed strong prognostic impact for Relapse-free survival (not reached vs 6.0 months) and overall survival (not reached vs 9.6 months) (p < 0.001 and 0.001, respectively). Initial stage (IV vs I-III) also showed different OS (not reached vs 9.6 months) but not RFS (p = 0.029 and 0.440, respectively). Other variables such as histological subtypes, age, IPI score showed no significance. Toxicity was often manageable and more than grade 3 of Seattle criteria was rare although five patients (0.11%) experienced 100 days-treatment-related mortality.

Conclusions

Upfront HD TBI-ASCT is tolerable and effective treatment strategy and might improve RFS and OS in selected patients.

Disclosure

All authors have declared no conflicts of interest.