The role of autologous stem cell transplantation in patients with nodal peripheral T-cell lymphomas in first complete remission

Report from COMPLETE, a prospective, multicenter cohort study

for the COMPLETE Investigators

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1507-1517
Number of pages11
JournalCancer
Volume125
Issue number9
DOIs
StatePublished - May 1 2019
Externally publishedYes

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Peripheral T-Cell Lymphoma
Stem Cell Transplantation
Multicenter Studies
Cohort Studies
Survival
T-Cell Lymphoma
Anaplastic Large-Cell Lymphoma
Disease-Free Survival
Lymphoma

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

@article{368a29daa9ef4a2e913c3fd77172a2fe,
title = "The role of autologous stem cell transplantation in patients with nodal peripheral T-cell lymphomas in first complete remission: Report from COMPLETE, a prospective, multicenter cohort study",
abstract = "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.",
author = "{for the COMPLETE Investigators} and Park, {Steven I.} and Horwitz, {Steven M.} and Foss, {Francine M.} and Pinter-Brown, {Lauren C.} and Carson, {Kenneth R.} and Rosen, {Steven T.} and Barbara Pro and Hsi, {Eric D.} and Massimo Federico and Christian Gisselbrecht and Marc Schwartz and Bellm, {Lisa A.} and Mark Acosta and Advani, {Ranjana H.} and Tatyana Feldman and Lechowicz, {Mary Jo} and Smith, {Sonali M.} and Frederick Lansigan and Anil Tulpule and Craig, {Michael D.} and Greer, {John P.} and Kahl, {Brad S.} and Leach, {Joseph W.} and Neil Morganstein and Carla Casulo and Shustov, {Andrei R.}",
year = "2019",
month = "5",
day = "1",
doi = "10.1002/cncr.31861",
language = "English (US)",
volume = "125",
pages = "1507--1517",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "9",

}

The role of autologous stem cell transplantation in patients with nodal peripheral T-cell lymphomas in first complete remission : Report from COMPLETE, a prospective, multicenter cohort study. / for the COMPLETE Investigators.

In: Cancer, Vol. 125, No. 9, 01.05.2019, p. 1507-1517.

Research output: Contribution to journalArticle

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.

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.

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U2 - 10.1002/cncr.31861

DO - 10.1002/cncr.31861

M3 - Article

VL - 125

SP - 1507

EP - 1517

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 9

ER -