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ASCT in PTCL: Enhancing Survival and Tailoring Treatment

May, 05, 2024 | Lymphoma

KEY TAKEAWAYS

  • The study aimed to compare real-world survival outcomes between consolidation therapy and observation in people with PTCL.
  • The study concluded that ASCT may enhance long-term survival in PTCL, especially for high-risk patients.

Little evidence exists regarding the use of autologous stem cell transplantation (ASCT) as consolidation therapy following remission induction in people with Peripheral T-cell lymphoma (PTCL).

Wulipan Fulati and the team aimed to conduct a comparative analysis of real-world survival outcomes between consolidation therapy and observation in patients with PTCL.

The study included 92 patients diagnosed with PTCL. They were categorized into 2 groups, including those who underwent high-dose therapy (HDT) followed by autologous hematopoietic stem cell transplantation (ASCT) as consolidation therapy (n=30) and those who received observation (n=62). They analyzed clinical characteristics, treatment patterns, and survival outcomes between the groups. Additionally, univariate and Cox multivariate regression analyses were conducted to identify prognostic factors of survival.

The results revealed that among peripheral T-cell lymphoma patients, those treated with ASCT had a median overall survival (OS) that was not reached within a median follow-up time of 41 months. Their median progression-free survival (PFS) was 77.0 months, significantly higher than patients without ASCT (P<0.003 for OS, P=0.015 for PFS).

Subgroup analysis indicated that ASCT provided greater benefits to patients with high risks. Independent prognostic factors associated with worse OS and PFS included a combination with hemophagocytic lymphohistiocytosis (HLH) (P<0.001), clinical stage beyond III (P=0.014), IPI score exceeding 3 (P=0.049), and bone marrow involvement (P=0.010).

Furthermore, a chemotherapy regimen containing pegylated liposomal doxorubicin (PLD) was linked to a higher overall response rate (ORR) and extended survival among PTCL patients who underwent ASCT.

The study concluded that ASCT could potentially enhance long-term survival among patients with PTCL, serving as a consolidation therapy post-remission induction, especially for individuals at high risk. Additionally, the chemotherapy regimen incorporating pegylated liposomal doxorubicin might induce a more profound remission compared to traditional doxorubicin in PTCL cases. Identifying specific groups most likely to benefit from upfront ASCT is deemed critical.

Funding was provided by the Shanghai Science and Technology Committee.

Source: https://pubmed.ncbi.nlm.nih.gov/38799461/

Fulati W, Ma J, Wu M, et al. (2024). “Consolidation therapy with autologous stem cell transplantation after remission of induction chemotherapy prolongs the survival of patients with peripheral T-cell lymphoma.” Front Immunol. 2024 May 10;15:1382189. doi: 10.3389/fimmu.2024.1382189. PMID: 38799461; PMCID: PMC11116632.

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