The adjusted International Prognostic Index and beta-2-microglobulin predict the outcome after autologous stem cell transplantation in relapsing/refractory peripheral T-cell lymphoma

Haematologica. 2007 Aug;92(8):1067-74. doi: 10.3324/haematol.11173. Epub 2007 Jul 20.

Abstract

Background and objectives: Preliminary data on the use of autologous stem cell transplantation (ASCT) as a salvage therapy for peripheral T-cell lymphoma (PTCL) indicate that the results are similar to those obtained in aggressive B-cell lymphomas. The aim of our study was to analyze outcomes of a large series of patients with PTCL with a prolonged follow-up who received ASCT as salvage therapy.

Design and methods: Between 1990 and 2004, 123 patients in this situation were registered in the GELTAMO database. The median age at transplantation was 43.5 years; in 91% of patients the disease was chemosensitive.

Results: Seventy-three percent of the patients achieved complete remission, 11% partial remission and the procedure failed in 16%. At a median follow-up of 61 months, the 5-year overall and progression-free survival rates were 45% and 34%, respectively. The presence of more than one factor of the adjusted International Prognostic Index (a-IPI) and a high beta2-microglobulin at transplantation were identified as adverse prognostic factors for both overall and progression-free survival and allowed the population to be stratified into three distinct risk groups.

Interpretation and conclusions: Our data show that approximately one third of patients with PTCL in the salvage setting may enjoy prolonged survival following ASCT, provided they are transplanted in a chemosensitive disease state. The a-IPI and beta2-microglobulin level predict the outcome after ASCT in relapsing/refractory PTCL.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers, Tumor / analysis*
  • Bone Marrow Transplantation* / statistics & numerical data
  • Combined Modality Therapy
  • Disease-Free Survival
  • Drug Resistance, Neoplasm
  • Female
  • Follow-Up Studies
  • Humans
  • Lymphoma, T-Cell, Peripheral / drug therapy
  • Lymphoma, T-Cell, Peripheral / mortality*
  • Lymphoma, T-Cell, Peripheral / surgery
  • Male
  • Middle Aged
  • Peripheral Blood Stem Cell Transplantation* / statistics & numerical data
  • Prognosis
  • Recurrence
  • Remission Induction
  • Salvage Therapy* / statistics & numerical data
  • Severity of Illness Index*
  • Survival Analysis
  • Survival Rate
  • Transplantation, Autologous
  • Treatment Outcome
  • beta 2-Microglobulin / analysis*

Substances

  • Biomarkers, Tumor
  • beta 2-Microglobulin