Up-Front Autologous Stem-Cell Transplantation in Peripheral T-Cell Lymphoma: NLG-T-01

Francesco d'Amore; Thomas Relander; Grete F Lauritzsen; Esa Jantunen; Hans Hagberg; Harald Anderson; Harald Holte; Anders Osterborg; Mats Merup; Peter De Nully Brown; Outi Kuittinen; Martin Erlanson; Bjørn Ostenstad; Unn-Merete Fagerli; Ole Vestergaard Gadeberg; Christer Sundström; Jan Delabie; Elisabeth Ralfkiaer; Martine Vornanen; Helle Toldbod

doi:10.1200/JCO.2011.40.2719

Up-Front Autologous Stem-Cell Transplantation in Peripheral T-Cell Lymphoma: NLG-T-01

Francesco d'Amore, Thomas Relander, Grete F Lauritzsen, Esa Jantunen, Hans Hagberg, Harald Anderson, Harald Holte, Anders Osterborg, Mats Merup, Peter De Nully Brown, Outi Kuittinen, Martin Erlanson, Bjørn Ostenstad, Unn-Merete Fagerli, Ole Vestergaard Gadeberg, Christer Sundström, Jan Delabie, Elisabeth Ralfkiaer, Martine Vornanen, Helle Toldbod

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

526 Citationer (Scopus)

Abstract

PURPOSE Systemic peripheral T-cell lymphomas (PTCLs) respond poorly to conventional therapy. To evaluate the efficacy of a dose-dense approach consolidated by up-front high-dose chemotherapy (HDT) and autologous stem-cell transplantation (ASCT) in PTCL, the Nordic Lymphoma Group (NLG) conducted a large prospective phase II study in untreated systemic PTCL. This is the final report, with a 5-year median follow-up, of the NLG-T-01 study. PATIENTS AND METHODS Treatment-naive patients with PTCL age 18 to 67 years (median, 57 years) were included. Anaplastic lymphoma kinase (ALK) -positive anaplastic large-cell lymphoma (ALCL) was excluded. An induction regimen of six cycles of biweekly CHOEP (cyclophosphamide, doxorubicin, vincristine, etoposide, and prednisone) was administered (in patients age > 60 years, etoposide was omitted). If in complete or partial remission, patients proceeded to consolidation with HDT/ASCT. Results Of 166 enrolled patients, 160 had histopathologically confirmed PTCL. The majority presented with advanced-stage disease, B symptoms, and elevated serum lactate dehydrogenase. A total of 115 underwent HDT/ASCT, with 90 in complete remission at 3 months post-transplantation. Early failures occurred in 26%. Treatment-related mortality was 4%. At 60.5 months of median follow-up, 83 patients were alive. Consolidated 5-year overall and progression-free survival (PFS) were 51% (95% CI, 43% to 59%) and 44% (95% CI, 36% to 52%), respectively. Best results were obtained in ALK-negative ALCL. CONCLUSION Dose-dense induction followed by HDT/ASCT was well tolerated and led to long-term PFS in 44% of treatment-naive patients with PTCL. This represents an encouraging outcome, particularly considering the high median age and adverse risk profile of the study population. Therefore, dose-dense induction and HDT/ASCT are a rational up-front strategy in transplantation-eligible patients with PTCL.

Originalsprog	Engelsk
Tidsskrift	Journal of Clinical Oncology
Vol/bind	30
Nummer	25
Sider (fra-til)	3093-9
Antal sider	7
ISSN	0732-183X
DOI	https://doi.org/10.1200/JCO.2011.40.2719
Status	Udgivet - 2012

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d'Amore, F., Relander, T., Lauritzsen, G. F., Jantunen, E., Hagberg, H., Anderson, H., Holte, H., Osterborg, A., Merup, M., Brown, P. D. N., Kuittinen, O., Erlanson, M., Ostenstad, B., Fagerli, U.-M., Gadeberg, O. V., Sundström, C., Delabie, J., Ralfkiaer, E., Vornanen, M., & Toldbod, H. (2012). Up-Front Autologous Stem-Cell Transplantation in Peripheral T-Cell Lymphoma: NLG-T-01. Journal of Clinical Oncology, 30(25), 3093-9. https://doi.org/10.1200/JCO.2011.40.2719

@article{39ea1485ea7c4368bfc639fd95105941,

title = "Up-Front Autologous Stem-Cell Transplantation in Peripheral T-Cell Lymphoma: NLG-T-01",

abstract = "PURPOSE Systemic peripheral T-cell lymphomas (PTCLs) respond poorly to conventional therapy. To evaluate the efficacy of a dose-dense approach consolidated by up-front high-dose chemotherapy (HDT) and autologous stem-cell transplantation (ASCT) in PTCL, the Nordic Lymphoma Group (NLG) conducted a large prospective phase II study in untreated systemic PTCL. This is the final report, with a 5-year median follow-up, of the NLG-T-01 study. PATIENTS AND METHODS Treatment-naive patients with PTCL age 18 to 67 years (median, 57 years) were included. Anaplastic lymphoma kinase (ALK) -positive anaplastic large-cell lymphoma (ALCL) was excluded. An induction regimen of six cycles of biweekly CHOEP (cyclophosphamide, doxorubicin, vincristine, etoposide, and prednisone) was administered (in patients age > 60 years, etoposide was omitted). If in complete or partial remission, patients proceeded to consolidation with HDT/ASCT. Results Of 166 enrolled patients, 160 had histopathologically confirmed PTCL. The majority presented with advanced-stage disease, B symptoms, and elevated serum lactate dehydrogenase. A total of 115 underwent HDT/ASCT, with 90 in complete remission at 3 months post-transplantation. Early failures occurred in 26%. Treatment-related mortality was 4%. At 60.5 months of median follow-up, 83 patients were alive. Consolidated 5-year overall and progression-free survival (PFS) were 51% (95% CI, 43% to 59%) and 44% (95% CI, 36% to 52%), respectively. Best results were obtained in ALK-negative ALCL. CONCLUSION Dose-dense induction followed by HDT/ASCT was well tolerated and led to long-term PFS in 44% of treatment-naive patients with PTCL. This represents an encouraging outcome, particularly considering the high median age and adverse risk profile of the study population. Therefore, dose-dense induction and HDT/ASCT are a rational up-front strategy in transplantation-eligible patients with PTCL.",

author = "Francesco d'Amore and Thomas Relander and Lauritzsen, {Grete F} and Esa Jantunen and Hans Hagberg and Harald Anderson and Harald Holte and Anders Osterborg and Mats Merup and Brown, {Peter De Nully} and Outi Kuittinen and Martin Erlanson and Bj{\o}rn Ostenstad and Unn-Merete Fagerli and Gadeberg, {Ole Vestergaard} and Christer Sundstr{\"o}m and Jan Delabie and Elisabeth Ralfkiaer and Martine Vornanen and Helle Toldbod",

year = "2012",

doi = "10.1200/JCO.2011.40.2719",

language = "English",

volume = "30",

pages = "3093--9",

journal = "Journal of Clinical Oncology",

issn = "0732-183X",

publisher = "Lippincott Williams and Wilkins",

number = "25",

}

d'Amore, F, Relander, T, Lauritzsen, GF, Jantunen, E, Hagberg, H, Anderson, H, Holte, H, Osterborg, A, Merup, M, Brown, PDN, Kuittinen, O, Erlanson, M, Ostenstad, B, Fagerli, U-M, Gadeberg, OV, Sundström, C, Delabie, J, Ralfkiaer, E, Vornanen, M & Toldbod, H 2012, 'Up-Front Autologous Stem-Cell Transplantation in Peripheral T-Cell Lymphoma: NLG-T-01', Journal of Clinical Oncology, bind 30, nr. 25, s. 3093-9. https://doi.org/10.1200/JCO.2011.40.2719

TY - JOUR

T1 - Up-Front Autologous Stem-Cell Transplantation in Peripheral T-Cell Lymphoma

T2 - NLG-T-01

AU - d'Amore, Francesco

AU - Relander, Thomas

AU - Lauritzsen, Grete F

AU - Jantunen, Esa

AU - Hagberg, Hans

AU - Anderson, Harald

AU - Holte, Harald

AU - Osterborg, Anders

AU - Merup, Mats

AU - Brown, Peter De Nully

AU - Kuittinen, Outi

AU - Erlanson, Martin

AU - Ostenstad, Bjørn

AU - Fagerli, Unn-Merete

AU - Gadeberg, Ole Vestergaard

AU - Sundström, Christer

AU - Delabie, Jan

AU - Ralfkiaer, Elisabeth

AU - Vornanen, Martine

AU - Toldbod, Helle

PY - 2012

Y1 - 2012

N2 - PURPOSE Systemic peripheral T-cell lymphomas (PTCLs) respond poorly to conventional therapy. To evaluate the efficacy of a dose-dense approach consolidated by up-front high-dose chemotherapy (HDT) and autologous stem-cell transplantation (ASCT) in PTCL, the Nordic Lymphoma Group (NLG) conducted a large prospective phase II study in untreated systemic PTCL. This is the final report, with a 5-year median follow-up, of the NLG-T-01 study. PATIENTS AND METHODS Treatment-naive patients with PTCL age 18 to 67 years (median, 57 years) were included. Anaplastic lymphoma kinase (ALK) -positive anaplastic large-cell lymphoma (ALCL) was excluded. An induction regimen of six cycles of biweekly CHOEP (cyclophosphamide, doxorubicin, vincristine, etoposide, and prednisone) was administered (in patients age > 60 years, etoposide was omitted). If in complete or partial remission, patients proceeded to consolidation with HDT/ASCT. Results Of 166 enrolled patients, 160 had histopathologically confirmed PTCL. The majority presented with advanced-stage disease, B symptoms, and elevated serum lactate dehydrogenase. A total of 115 underwent HDT/ASCT, with 90 in complete remission at 3 months post-transplantation. Early failures occurred in 26%. Treatment-related mortality was 4%. At 60.5 months of median follow-up, 83 patients were alive. Consolidated 5-year overall and progression-free survival (PFS) were 51% (95% CI, 43% to 59%) and 44% (95% CI, 36% to 52%), respectively. Best results were obtained in ALK-negative ALCL. CONCLUSION Dose-dense induction followed by HDT/ASCT was well tolerated and led to long-term PFS in 44% of treatment-naive patients with PTCL. This represents an encouraging outcome, particularly considering the high median age and adverse risk profile of the study population. Therefore, dose-dense induction and HDT/ASCT are a rational up-front strategy in transplantation-eligible patients with PTCL.

AB - PURPOSE Systemic peripheral T-cell lymphomas (PTCLs) respond poorly to conventional therapy. To evaluate the efficacy of a dose-dense approach consolidated by up-front high-dose chemotherapy (HDT) and autologous stem-cell transplantation (ASCT) in PTCL, the Nordic Lymphoma Group (NLG) conducted a large prospective phase II study in untreated systemic PTCL. This is the final report, with a 5-year median follow-up, of the NLG-T-01 study. PATIENTS AND METHODS Treatment-naive patients with PTCL age 18 to 67 years (median, 57 years) were included. Anaplastic lymphoma kinase (ALK) -positive anaplastic large-cell lymphoma (ALCL) was excluded. An induction regimen of six cycles of biweekly CHOEP (cyclophosphamide, doxorubicin, vincristine, etoposide, and prednisone) was administered (in patients age > 60 years, etoposide was omitted). If in complete or partial remission, patients proceeded to consolidation with HDT/ASCT. Results Of 166 enrolled patients, 160 had histopathologically confirmed PTCL. The majority presented with advanced-stage disease, B symptoms, and elevated serum lactate dehydrogenase. A total of 115 underwent HDT/ASCT, with 90 in complete remission at 3 months post-transplantation. Early failures occurred in 26%. Treatment-related mortality was 4%. At 60.5 months of median follow-up, 83 patients were alive. Consolidated 5-year overall and progression-free survival (PFS) were 51% (95% CI, 43% to 59%) and 44% (95% CI, 36% to 52%), respectively. Best results were obtained in ALK-negative ALCL. CONCLUSION Dose-dense induction followed by HDT/ASCT was well tolerated and led to long-term PFS in 44% of treatment-naive patients with PTCL. This represents an encouraging outcome, particularly considering the high median age and adverse risk profile of the study population. Therefore, dose-dense induction and HDT/ASCT are a rational up-front strategy in transplantation-eligible patients with PTCL.

U2 - 10.1200/JCO.2011.40.2719

DO - 10.1200/JCO.2011.40.2719

M3 - Journal article

C2 - 22851556

SN - 0732-183X

VL - 30

SP - 3093

EP - 3099

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

IS - 25

ER -

Up-Front Autologous Stem-Cell Transplantation in Peripheral T-Cell Lymphoma: NLG-T-01

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