PTCL is an unfavourable group of aggressive malignant lymphomas despite conventional chemotherapy. High-dose chemotherapy followed by autologous HSCT (HDT/ASCT) and allogeneic HSCT are important treatment options for selected patients with aggressive lymphomas. To investigate the role of HSCT, we planned retrospective analysis in our institute.
We performed a retrospective analysis of 68 patients with PTCL (39 PTCL-not otherwise specified, 22 angioimmunoblastic T-cell lymphoma, 3 anaplastic large cell lymphoma (ALCL) with anaplastic lymphoma kinase (ALK)-positive, 4 ALCL with ALK-negative) who were diagnosed between August 1993 and July 2015 in our institute.
Median follow-up time from the diagnosis was 2.2 years (range, 0.1-19.8), and median age was 64 years (range, 20-93). Median progression free survival from initial therapy was 1.1 years and median survival time was 4.3 years in all patients. All the patients received conventional chemotherapy. Response to the initial chemotherapy could be assessed in 61 patients. Thirty-three patients (54%) achieved CR, 18 patients were PR (29%). Fifty patients received only chemotherapy. HDT/ASCT was performed in 14 patients (tandem HDT/ASCT was performed in 1 patient). Allogeneic HSCT was performed in 6 patients, 2 out of 6 patients received HDT/ASCT before allogeneic HSCT. Median survival time was 14.3 years in HDT/ASCT at CR1/PR1 group, 3.2 years in other group, respectively. Those who received HDT/ASCT in CR1/PR1 had better prognosis than the other patients significantly (P = 0.003).
Poor prognosis of PTCL with only chemotherapy has been confirmed as previous reports. This attributed to both of the absence of additional agents such as rituximab for B-cell lymphoma and low CR rate for initial therapy. There is a certain benefit of HDT/ASCT for PTCL patients in CR1/PR1. Although HDT/ASCT for selected patients is still an important therapeutic option, stratification strategy to distinguish who can achieve more beneficial results by HSCT has not been established.
Clinical trial identification
All authors have declared no conflicts of interest.