Peripheral T-cell lymphoma: the role of hematopoietic stem cell transplantation

Abstract

Peripheral T-cell lymphoma (PTCL) is a rare and heterogeneous group of non-Hodgkin lymphomas (NHLs). Whereas the incidence of the disease appears to increase during last decades and the prognosis remains dramatically poor, so far no standard treatment has been established. High-dose chemotherapy and autologous stem cell transplantation (HDT-ASCT) has been proven effective in relapsed PTCL, while retrospective studies have shown a survival benefit as first-line treatment in some subsets of PTCL patients. However, given disease rarity, there is a paucity of randomized trials in both upfront and relapse setting. Here, we critically evaluated eligible prospective and retrospective studies that address the role of ASCT in treatment of PTCL, with respect to quality of design and performance. Additionally, the role of allogeneic transplantation has been reviewed. The comparison of ASCT with novel agents that emerge or the combination of both, are to be ascertained via prospective randomized trials in this field.

Keywords: ACVBP; AITL; ALCL; ALK; ASCT; ATG; AaIPI; Allo-SCT; Autologous stem cell transplantation; B; BCNU; BCNU, etoposide, cyclophosphamide; BCNU, etoposide, cytarabin, cyclophosphamide; BCNU, etoposide, cytarabin, melphalan; BEAC; BEAM; BEC; C; CEOP; CHOEP; CR; CTCL; CVB; CVB/CBV; Cyt; DFS; DHAP; DLBL; E; EATL; ECVBP; EFS; Flu; GVHD; HSTL; High-dose chemotherapy; ICE; IFE; IPI; ITTP; MA/MAC; MCEC; Mel; Mito; NK; NK/T; NRM; ORR; OS; P; PFS; PIF; PR; PTCL; Peripheral T-cell lymphoma; ProMACE-CytBOM; RIC; TBI; TRM; TTF; Thio; Transplantation; W; Y; age-adjusted IPI; allogeneic stem cell transplantation; anaplastic large cell lymphoma; anaplastic lymphoma kinase; angioimmunoblastic T-cell lymphoma; anti-thymocyte globulin; autologous stem cell transplantation; busulfan; busulfan, etoposide, cyclophosphamide; carmustine; cisplatin; complete response (CR1/2 first/second complete remission); cutaneous T-cell lymphoma; cyclophosphamide; cyclophosphamide, epirubicin, vincristine, prednisone; cyclophosphamide, vincristine, doxorubicin, etoposide, prednisone; cytarabin; dexamethasone, cytarabine, cisplatin; diffuse large B-cell lymphoma; disease-free survival; doxorubicin, cyclophosphamide, vindesine, bleomycin, prednisone, intrathecal methotrexate; enteropathy-associated T-cell lymphoma; epirubicin, cyclophosphamide, vindesine, bleomycin, prednisone; etoposide; event-free survival; fludarabine; graft-versus-host disease; hepatosplenic T-cell lymphoma; ifosfamide, carboplatin, etoposide; ifosfamide, etoposide; intention to treat population; international prognostic index; melphalan; mitoxantrone; myeloablative conditioning; natural killer cell; natural killer-cell/T-cell leukemia/lymphoma; non-relapse mortality; overall response rate; overall survival; partial remission; prednisone, methotrexate, doxorubicin, cyclophosphamide, etoposide–cytarabine, bleomycin, vincristine, methotrexate; primary induction failure; progression-free survival; ranimustine, cyclophosphamide, etoposide, carboplatin; reduced intensity conditioning; thiotepa; time to treatment failure; total body irradiation; treatment-related mortality; weeks; year.