The outcome of peripheral t-cell lymphoma patients failing first-line therapy

A report from the prospective, international t-cell project

International T-cell Project Network

Research output: Contribution to journalArticle

Abstract

This analysis explored factors influencing survival of patients with primary refractory and relapsed peripheral T-cell lymphomas enrolled in the prospective International T-cell Project. We analyzed data from 1020 patients with newly diagnosed disease, enrolled between September 2006 and December 2015. Out of 937 patients who received first-line treatment, 436 (47%) were identified as refractory and 197 (21%) as relapsed. Median time from the end of treatment to relapse was 8 months (range 2-73). Overall, 75 patients (8%) were consolidated with bone marrow transplantation, including 12 refractory and 22 relapsed patients. After a median follow up of 38 months (range 1-96 months) from documentation of refractory/relapsed disease, 440 patients had died. The median overall survival (OS) was 5.8 months; 3-year overall survival rates were 21% and 28% for refractory and relapsed patients, respectively (P<0.001). Patients receiving or not salvage bone marrow transplantation had a 3-year survival of 48% and 18%, respectively (P<0.001). In a univariate Cox regression analysis, refractory disease was associated with a higher risk of death (HR=1.43, P=0.001), whereas late relapse (>12 months, HR 0.57, P=0.001) and salvage therapy with transplantation (HR=0.36, P<0.001) were associated with a better OS. No difference was found in OS with respect to histology. This study accurately reflects outcomes for patients treated according to standards of care worldwide. Results confirm that peripheral T-cell lymphomas patients had dismal outcome after relapse or progression. Patients with chemotherapy sensitive disease who relapsed after more than 12 months might benefit from consolidation bone marrow transplantation. (Registered at clinicaltrials.gov identifier: 01142674).

Original languageEnglish
Pages (from-to)1191-1197
Number of pages7
JournalHaematologica
Volume103
Issue number7
DOIs
Publication statusPublished - Jul 3 2018

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Lymphoma
Peripheral T-Cell Lymphoma
Therapeutics
Survival
Bone Marrow Transplantation
Recurrence
Salvage Therapy
Standard of Care
Documentation
Statistical Factor Analysis
Histology
Survival Rate
Transplantation
T-Lymphocytes
Drug Therapy

ASJC Scopus subject areas

  • Hematology

Cite this

The outcome of peripheral t-cell lymphoma patients failing first-line therapy : A report from the prospective, international t-cell project. / International T-cell Project Network.

In: Haematologica, Vol. 103, No. 7, 03.07.2018, p. 1191-1197.

Research output: Contribution to journalArticle

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abstract = "This analysis explored factors influencing survival of patients with primary refractory and relapsed peripheral T-cell lymphomas enrolled in the prospective International T-cell Project. We analyzed data from 1020 patients with newly diagnosed disease, enrolled between September 2006 and December 2015. Out of 937 patients who received first-line treatment, 436 (47{\%}) were identified as refractory and 197 (21{\%}) as relapsed. Median time from the end of treatment to relapse was 8 months (range 2-73). Overall, 75 patients (8{\%}) were consolidated with bone marrow transplantation, including 12 refractory and 22 relapsed patients. After a median follow up of 38 months (range 1-96 months) from documentation of refractory/relapsed disease, 440 patients had died. The median overall survival (OS) was 5.8 months; 3-year overall survival rates were 21{\%} and 28{\%} for refractory and relapsed patients, respectively (P<0.001). Patients receiving or not salvage bone marrow transplantation had a 3-year survival of 48{\%} and 18{\%}, respectively (P<0.001). In a univariate Cox regression analysis, refractory disease was associated with a higher risk of death (HR=1.43, P=0.001), whereas late relapse (>12 months, HR 0.57, P=0.001) and salvage therapy with transplantation (HR=0.36, P<0.001) were associated with a better OS. No difference was found in OS with respect to histology. This study accurately reflects outcomes for patients treated according to standards of care worldwide. Results confirm that peripheral T-cell lymphomas patients had dismal outcome after relapse or progression. Patients with chemotherapy sensitive disease who relapsed after more than 12 months might benefit from consolidation bone marrow transplantation. (Registered at clinicaltrials.gov identifier: 01142674).",
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