Hematopoietic cell transplantation for systemic mature T-cell non-hodgkin lymphoma.

Sonali M. Smith, Linda J. Burns, Koen van Besien, Jennifer Lerademacher, Wensheng He, Timothy S. Fenske, Ritsuro Suzuki, Jack W. Hsu, Harry C. Schouten, Gregory A. Hale, Leona A. Holmberg, Anna Sureda, Cesar O. Freytes, Richard Thomas Maziarz, David J. Inwards, Robert Peter Gale, Thomas G. Gross, Mitchell S. Cairo, Luciano J. Costa, Hillard M. LazarusPeter H. Wiernik, Dipnarine Maharaj, Ginna G. Laport, Silvia Montoto, Parameswaran N. Hari

Research output: Contribution to journalArticle

97 Citations (Scopus)

Abstract

To analyze outcomes of hematopoietic cell transplantation (HCT) in T-cell non-Hodgkin lymphoma. Outcomes of 241 patients (112 anaplastic large-cell lymphoma, 102 peripheral T-cell lymphoma not otherwise specified, 27 angioimmunoblastic T-cell lymphoma) undergoing autologous HCT (autoHCT; n = 115; median age, 43 years) or allogeneic HCT (alloHCT; n = 126; median age, 38 years) were analyzed. Primary outcomes were nonrelapse mortality (NRM), relapse/progression, progression-free survival (PFS), and overall survival (OS). Patient, disease, and HCT-related variables were analyzed in multivariate Cox proportional hazard models to determine association with outcomes. AutoHCT recipients were more likely in first complete remission (CR1; 35% v 14%; P = .001) and with chemotherapy-sensitive disease (86% v 60%; P < .001), anaplastic large-cell histology (53% v 40%; P = .04), and two or fewer lines of prior therapy (65% v 44%; P < .001) compared with alloHCT recipients. Three-year PFS and OS of autoHCT recipients beyond CR1 were 42% and 53%, respectively. Among alloHCT recipients who received transplantations beyond CR1, 31% remained progression-free at 3 years, despite being more heavily pretreated and with more refractory disease. NRM was 3.5-fold higher (95% CI, 1.80 to 6.99; P < .001) for alloHCT. In multivariate analysis, chemotherapy sensitivity (hazard ratio [HR], 1.8; 95% CI, 1.16 to 2.87) and two or fewer lines of pretransplantation therapy (HR, 5.02; 95% CI, 2.15 to 11.72) were prognostic of survival. These data describe the roles of autoHCT and alloHCT in T-cell non-Hodgkin lymphoma and suggest greater effectiveness earlier in the disease course, and limited utility in multiply relapsed disease. Notably, autoHCT at relapse may be a potential option for select patients, particularly those with anaplastic large-cell lymphoma histology.

Original languageEnglish (US)
Pages (from-to)3100-3109
Number of pages10
JournalJournal of clinical oncology : official journal of the American Society of Clinical Oncology
Volume31
Issue number25
DOIs
StatePublished - Sep 1 2013

Fingerprint

T-Cell Lymphoma
Cell Transplantation
Non-Hodgkin's Lymphoma
Anaplastic Large-Cell Lymphoma
Disease-Free Survival
Survival
Histology
Peripheral T-Cell Lymphoma
Recurrence
Drug Therapy
Mortality
Proportional Hazards Models
Multivariate Analysis
Transplantation
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Hematopoietic cell transplantation for systemic mature T-cell non-hodgkin lymphoma. / Smith, Sonali M.; Burns, Linda J.; van Besien, Koen; Lerademacher, Jennifer; He, Wensheng; Fenske, Timothy S.; Suzuki, Ritsuro; Hsu, Jack W.; Schouten, Harry C.; Hale, Gregory A.; Holmberg, Leona A.; Sureda, Anna; Freytes, Cesar O.; Maziarz, Richard Thomas; Inwards, David J.; Gale, Robert Peter; Gross, Thomas G.; Cairo, Mitchell S.; Costa, Luciano J.; Lazarus, Hillard M.; Wiernik, Peter H.; Maharaj, Dipnarine; Laport, Ginna G.; Montoto, Silvia; Hari, Parameswaran N.

In: Journal of clinical oncology : official journal of the American Society of Clinical Oncology, Vol. 31, No. 25, 01.09.2013, p. 3100-3109.

Research output: Contribution to journalArticle

Smith, SM, Burns, LJ, van Besien, K, Lerademacher, J, He, W, Fenske, TS, Suzuki, R, Hsu, JW, Schouten, HC, Hale, GA, Holmberg, LA, Sureda, A, Freytes, CO, Maziarz, RT, Inwards, DJ, Gale, RP, Gross, TG, Cairo, MS, Costa, LJ, Lazarus, HM, Wiernik, PH, Maharaj, D, Laport, GG, Montoto, S & Hari, PN 2013, 'Hematopoietic cell transplantation for systemic mature T-cell non-hodgkin lymphoma.', Journal of clinical oncology : official journal of the American Society of Clinical Oncology, vol. 31, no. 25, pp. 3100-3109. https://doi.org/10.1200/JCO.2012.46.0188
Smith, Sonali M. ; Burns, Linda J. ; van Besien, Koen ; Lerademacher, Jennifer ; He, Wensheng ; Fenske, Timothy S. ; Suzuki, Ritsuro ; Hsu, Jack W. ; Schouten, Harry C. ; Hale, Gregory A. ; Holmberg, Leona A. ; Sureda, Anna ; Freytes, Cesar O. ; Maziarz, Richard Thomas ; Inwards, David J. ; Gale, Robert Peter ; Gross, Thomas G. ; Cairo, Mitchell S. ; Costa, Luciano J. ; Lazarus, Hillard M. ; Wiernik, Peter H. ; Maharaj, Dipnarine ; Laport, Ginna G. ; Montoto, Silvia ; Hari, Parameswaran N. / Hematopoietic cell transplantation for systemic mature T-cell non-hodgkin lymphoma. In: Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2013 ; Vol. 31, No. 25. pp. 3100-3109.
@article{ad8b1c2bb55844d68606bb665e2f43b7,
title = "Hematopoietic cell transplantation for systemic mature T-cell non-hodgkin lymphoma.",
abstract = "To analyze outcomes of hematopoietic cell transplantation (HCT) in T-cell non-Hodgkin lymphoma. Outcomes of 241 patients (112 anaplastic large-cell lymphoma, 102 peripheral T-cell lymphoma not otherwise specified, 27 angioimmunoblastic T-cell lymphoma) undergoing autologous HCT (autoHCT; n = 115; median age, 43 years) or allogeneic HCT (alloHCT; n = 126; median age, 38 years) were analyzed. Primary outcomes were nonrelapse mortality (NRM), relapse/progression, progression-free survival (PFS), and overall survival (OS). Patient, disease, and HCT-related variables were analyzed in multivariate Cox proportional hazard models to determine association with outcomes. AutoHCT recipients were more likely in first complete remission (CR1; 35{\%} v 14{\%}; P = .001) and with chemotherapy-sensitive disease (86{\%} v 60{\%}; P < .001), anaplastic large-cell histology (53{\%} v 40{\%}; P = .04), and two or fewer lines of prior therapy (65{\%} v 44{\%}; P < .001) compared with alloHCT recipients. Three-year PFS and OS of autoHCT recipients beyond CR1 were 42{\%} and 53{\%}, respectively. Among alloHCT recipients who received transplantations beyond CR1, 31{\%} remained progression-free at 3 years, despite being more heavily pretreated and with more refractory disease. NRM was 3.5-fold higher (95{\%} CI, 1.80 to 6.99; P < .001) for alloHCT. In multivariate analysis, chemotherapy sensitivity (hazard ratio [HR], 1.8; 95{\%} CI, 1.16 to 2.87) and two or fewer lines of pretransplantation therapy (HR, 5.02; 95{\%} CI, 2.15 to 11.72) were prognostic of survival. These data describe the roles of autoHCT and alloHCT in T-cell non-Hodgkin lymphoma and suggest greater effectiveness earlier in the disease course, and limited utility in multiply relapsed disease. Notably, autoHCT at relapse may be a potential option for select patients, particularly those with anaplastic large-cell lymphoma histology.",
author = "Smith, {Sonali M.} and Burns, {Linda J.} and {van Besien}, Koen and Jennifer Lerademacher and Wensheng He and Fenske, {Timothy S.} and Ritsuro Suzuki and Hsu, {Jack W.} and Schouten, {Harry C.} and Hale, {Gregory A.} and Holmberg, {Leona A.} and Anna Sureda and Freytes, {Cesar O.} and Maziarz, {Richard Thomas} and Inwards, {David J.} and Gale, {Robert Peter} and Gross, {Thomas G.} and Cairo, {Mitchell S.} and Costa, {Luciano J.} and Lazarus, {Hillard M.} and Wiernik, {Peter H.} and Dipnarine Maharaj and Laport, {Ginna G.} and Silvia Montoto and Hari, {Parameswaran N.}",
year = "2013",
month = "9",
day = "1",
doi = "10.1200/JCO.2012.46.0188",
language = "English (US)",
volume = "31",
pages = "3100--3109",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "25",

}

TY - JOUR

T1 - Hematopoietic cell transplantation for systemic mature T-cell non-hodgkin lymphoma.

AU - Smith, Sonali M.

AU - Burns, Linda J.

AU - van Besien, Koen

AU - Lerademacher, Jennifer

AU - He, Wensheng

AU - Fenske, Timothy S.

AU - Suzuki, Ritsuro

AU - Hsu, Jack W.

AU - Schouten, Harry C.

AU - Hale, Gregory A.

AU - Holmberg, Leona A.

AU - Sureda, Anna

AU - Freytes, Cesar O.

AU - Maziarz, Richard Thomas

AU - Inwards, David J.

AU - Gale, Robert Peter

AU - Gross, Thomas G.

AU - Cairo, Mitchell S.

AU - Costa, Luciano J.

AU - Lazarus, Hillard M.

AU - Wiernik, Peter H.

AU - Maharaj, Dipnarine

AU - Laport, Ginna G.

AU - Montoto, Silvia

AU - Hari, Parameswaran N.

PY - 2013/9/1

Y1 - 2013/9/1

N2 - To analyze outcomes of hematopoietic cell transplantation (HCT) in T-cell non-Hodgkin lymphoma. Outcomes of 241 patients (112 anaplastic large-cell lymphoma, 102 peripheral T-cell lymphoma not otherwise specified, 27 angioimmunoblastic T-cell lymphoma) undergoing autologous HCT (autoHCT; n = 115; median age, 43 years) or allogeneic HCT (alloHCT; n = 126; median age, 38 years) were analyzed. Primary outcomes were nonrelapse mortality (NRM), relapse/progression, progression-free survival (PFS), and overall survival (OS). Patient, disease, and HCT-related variables were analyzed in multivariate Cox proportional hazard models to determine association with outcomes. AutoHCT recipients were more likely in first complete remission (CR1; 35% v 14%; P = .001) and with chemotherapy-sensitive disease (86% v 60%; P < .001), anaplastic large-cell histology (53% v 40%; P = .04), and two or fewer lines of prior therapy (65% v 44%; P < .001) compared with alloHCT recipients. Three-year PFS and OS of autoHCT recipients beyond CR1 were 42% and 53%, respectively. Among alloHCT recipients who received transplantations beyond CR1, 31% remained progression-free at 3 years, despite being more heavily pretreated and with more refractory disease. NRM was 3.5-fold higher (95% CI, 1.80 to 6.99; P < .001) for alloHCT. In multivariate analysis, chemotherapy sensitivity (hazard ratio [HR], 1.8; 95% CI, 1.16 to 2.87) and two or fewer lines of pretransplantation therapy (HR, 5.02; 95% CI, 2.15 to 11.72) were prognostic of survival. These data describe the roles of autoHCT and alloHCT in T-cell non-Hodgkin lymphoma and suggest greater effectiveness earlier in the disease course, and limited utility in multiply relapsed disease. Notably, autoHCT at relapse may be a potential option for select patients, particularly those with anaplastic large-cell lymphoma histology.

AB - To analyze outcomes of hematopoietic cell transplantation (HCT) in T-cell non-Hodgkin lymphoma. Outcomes of 241 patients (112 anaplastic large-cell lymphoma, 102 peripheral T-cell lymphoma not otherwise specified, 27 angioimmunoblastic T-cell lymphoma) undergoing autologous HCT (autoHCT; n = 115; median age, 43 years) or allogeneic HCT (alloHCT; n = 126; median age, 38 years) were analyzed. Primary outcomes were nonrelapse mortality (NRM), relapse/progression, progression-free survival (PFS), and overall survival (OS). Patient, disease, and HCT-related variables were analyzed in multivariate Cox proportional hazard models to determine association with outcomes. AutoHCT recipients were more likely in first complete remission (CR1; 35% v 14%; P = .001) and with chemotherapy-sensitive disease (86% v 60%; P < .001), anaplastic large-cell histology (53% v 40%; P = .04), and two or fewer lines of prior therapy (65% v 44%; P < .001) compared with alloHCT recipients. Three-year PFS and OS of autoHCT recipients beyond CR1 were 42% and 53%, respectively. Among alloHCT recipients who received transplantations beyond CR1, 31% remained progression-free at 3 years, despite being more heavily pretreated and with more refractory disease. NRM was 3.5-fold higher (95% CI, 1.80 to 6.99; P < .001) for alloHCT. In multivariate analysis, chemotherapy sensitivity (hazard ratio [HR], 1.8; 95% CI, 1.16 to 2.87) and two or fewer lines of pretransplantation therapy (HR, 5.02; 95% CI, 2.15 to 11.72) were prognostic of survival. These data describe the roles of autoHCT and alloHCT in T-cell non-Hodgkin lymphoma and suggest greater effectiveness earlier in the disease course, and limited utility in multiply relapsed disease. Notably, autoHCT at relapse may be a potential option for select patients, particularly those with anaplastic large-cell lymphoma histology.

UR - http://www.scopus.com/inward/record.url?scp=84886463678&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84886463678&partnerID=8YFLogxK

U2 - 10.1200/JCO.2012.46.0188

DO - 10.1200/JCO.2012.46.0188

M3 - Article

C2 - 23897963

AN - SCOPUS:84886463678

VL - 31

SP - 3100

EP - 3109

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 25

ER -