In:
Blood, American Society of Hematology, Vol. 112, No. 11 ( 2008-11-16), p. 1141-1141
Abstract:
In order to determine the long-term impact of AUTO in patients (pts) with T-cell lymphoma, we examined the outcome of 79 pts transplanted at the MD Anderson Cancer Center, in first partial or complete remission (CR) (AUTO1, n=20) or for relapsed / refractory disease (AUTO2, n=59) between 06/91 and 05/08. & lt; & lt; & lt;PATIENTS & gt; & gt; & gt; Median age (range) at transplantation was 49 (22–65) and 51 (16–77) for the AUTO1 and AUTO2 groups respectively (p=0.35); other baseline characteristics including gender, stage, B-symptoms, LDH, IPI, PET/Gallium status, history of marrow involvement, and performance status at transplantation were similar. There was a statistically significant difference between AUTO1 and AUTO2 with respect to histology {peripheral t-cell, angioimmunoblatic, and anaplastic/large cell were present in 80%, 5%, 15%, respectively in AUTO1, and 42%, 10%, and 45%, respectively in AUTO2 (p=0.02); one pt in AUTO2 had small lymphocytic and one had hepatosplenic T cell lymphoma}. Statistically significant differences were also noted with respect to B2-microglobulin (P=0.02; favoring AUTO1), number of prior chemotherapy regimens received {median 1 vs 3 for AUTO1 and AUTO2, respectively (p & lt;0.001)}, disease status at transplantation {18% of AUTO2 had stable or progressive disease at transplant vs 0% in AUTO1 (P & lt; 0.001)}, and # of CD34+cellsx10 6/Kg infused {median 9 vs 5 for AUTO1 and AUTO2, respectively}. Most pts in both group received BEAM as conditioning. Median follow-up time in months was 64 (95%CI, 31–87), and 47(95%CI29–121) for AUTO1 and AUTO, respectively. Median overall survival (OS) was 43.5 months (95%CI:30–70 for AUTO2 and the median OS was not reached for AUTO1 (P=0.01)(Figure). The median progression-free survival (PFS) was 16 months (95%CI:8–56) and 95 months (95%CI:6.94-NA) for the pts in the AUTO2 and AUTO1 groups, respectively (P=0.06). Univariate Cox models for OS showed that AUTO2 vs AUTO1 (HR 3.4, P=0.02), high LDH level (HR 2.6. P=0.01), PET/Gallium+ (HR 2.8, P=0.01), IPI2–4 (HR 3.4, P=0.002), marrow involvement (HR 6.3, P=0.02), and marrow vs peripheral blood as source of graft (HR 2.1, P=0.048) were important determinants of outcome. The univariate Cox model for PFS showed that only AUTO2 vs AUTO1, hi LDH, IPI and PET/gallium were statistically significant. A multivariate analysis that included the covariates with the lowest P value showed that AUTO2 vs AUTO1 remained the only important factor for OS (HR 4.79, P=0.035) while PET/ Gallium status at transplantation was the most important determinant of PFS (HR 3.13, P=0.006). & lt; & lt; & lt;CONCLUSION & gt; & gt; & gt; Autologous transplantation has the potential to cure a proportion of pts with t-cell lymphoma if performed during the first remission. Alternative strategies are needed for pts transplanted beyond first remission especially if they continue to have avid functional imaging at transplantation. Figure Figure
Type of Medium:
Online Resource
ISSN:
0006-4971
,
1528-0020
DOI:
10.1182/blood.V112.11.1141.1141
Language:
English
Publisher:
American Society of Hematology
Publication Date:
2008
detail.hit.zdb_id:
1468538-3
detail.hit.zdb_id:
80069-7
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