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denotes that this is a ticketed session.Program: Oral and Poster Abstracts
Session: 732. Clinical Allogeneic Transplantation: Results: Poster III
Purpose
We present the result of a comparison study between conventional chemotherapy and HCT for Peripheral T-cell lymphomas (PTCLs) in our center, especially the comparison between allo-HCT and auto-HCT.
Patients and Methods
From July 2007 to July 2014, 112 cases were analyzed retrospectively. All 112 patients were high risk group (IPI®3-4), 52 patients received conventional chemotherapy alone and 60 patients underwent HCT. In HCT group, Twenty-one (36.5%) patients received allo-HCT and thirty-nine patients (63.5%) received auto-HCT. Before receiving transplantation, 40 patients were in complete remission (CR), 2 patients were in partial remission (PR) and 18 patients were in refractory or relapse (NR). In the 18 NR patients, 11 patients accepted allo-HCT and 7 patients accepted auto-HCT. Patients¡¯ baseline characteristics were listed in Table 1 and Table 2.
Results
In this study, the longest follow-up time was 76 months and the shortest follow-up time was only two months. After chemotherapy, 31/52 patients achieved complete remission (CR)£¬5/52 patients achieved PR and 16/52 patients were not remission£¡§NR). The overall response rate was 69.2%. However, 14 patients suffered relapse in 36 responding patients, the recurrence rate was close to 50%. In allo-HCT group, 19/21 patients achieved CR and 2/21 patients died of severe infection within 100 days after HCT. In auto-HCT patients, 35/39 patients achieved CR and 4/39 patients were in NR. 7 patients experienced relapse after auto-HCT.
After a median follow-up of 33.5 months, the K-M analysis showed that the 5-year PFS for HCT and chemotherapy were 60% and 30% (p=0.006), the 5-year OS were 65% and 33% (p=0.007). The difference between the two groups was significant The 5-year PFS for auto-HCT and allo-HCT were 61% and 60% (p=0.724). The 5-year OS were 62% and 61% (p=0.724). In transplant group, the 5-year OS for patients who were CR or NR before transplantation were 81% and 53% (p=0.303). The one-year cumulative TRM of allo-HCT and auto-HCT were 22.5% and 7.8% (p=0.250). For patients whose ages are below 50, the 2-year PFS for HCT and chemotherapy were 62.7% and 34.8% (p=0.017), the 3-year OS were 71.2% and 36.7% (p=0.033). The one-year TRM of HCT and chemotherapy were 15.5% and 12.4% (p=0.203). For patients more than 50 years old, the 1-year OS for HCT and chemotherapy were 85.7% and 66.5% (p=0.384). And the one-year TRM of HCT and chemotherapy were 28.6% and 33.3% (p=0.352).
Conclusion
The majorities of PTCL patients are at high risk and have a high recurrence rate after conventional chemotherapy alone. Our results suggest that HCT is superior to conventional chemotherapy in long-term survival for PTCLs and HCT is feasible for high-risk patients with low TRM, especially in the young patients. Therefore, HCT should be considered to be the first-line therapy in high risk PTCL patients. As to PFS and OS, there seems to be no difference between auto-HCT and allo-HCT. While before transplantation, there are more NR and relapsed patients in allo-HCT group, we recommend allo-HCT for refractory and relapsed patients.
Table 1: Patient characteristics
Parameters |
Chemotherapy |
HCT |
p value |
Number Gender(female/male) Median Age Histological subtypes PTCL-NOS ALK-negative ALCL AITL NK/T High risk factors B-symptoms IPI score ®3 Ann Arbor III-IV stage Evaluated LDH Response to chemotherapy CR PR NR Responses to transplantation CR PR NR Uncertain |
52 16/36 45
9 15 15 13
27 52 40 40
31 5 16 N |
60 16/44 29
17 15 17 11
25 60 40 42
40 2 18
54 0 4 2 |
0.521 0.003 N
0.436 1.000 0.376 0.546 N
N |
Table 2: Patient characteristics of transplantation group
Parameters |
Auto-HCT |
Allo-HCT |
Number Histological subtypes PTCL-NOS ALK-negative ALCL AITL NK/T Conditioning regimen BEAM BUCY TBI+BUCY Donor source Matched unrelated donor Matched sibling donor Haploid donor Cord blood Disease status before HCT CR PR NR Disease status after HCT CR PR NR uncertain |
39
12 13 7 7
39 0 0 N
30 2 7
35 0 4 0 |
21
4 4 9 4
0 11 10
8 4 8 1
10 0 11
19 0 0 2 |
Disclosures: No relevant conflicts of interest to declare.
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