Artículos de revistas
The outcome of peripheral T-cell lymphoma patients failing first-line therapy: a report from the prospective, International T-Cell Project
Fecha
2018-07-03Registro en:
Haematologica, 103(7), 03 julio 2018, 1191-1197 pp.
0390-6078
10.3324/haematol.2017.186577
Autor
Bellei, Mónica
Foss, Francine M.
Shustov, Andrei
Horwitz, Steven M.
Marcheselli, Luigi
Kim, Won Seog
Cabrera, María Elena
Dlouhy, Iván
Nagler, Arnon
Advani, Ranjana H.
Pesce, Emanuela Anna
Ko, Young-Hyeh
Martínez, Virginia
Montoto, Silvia
Chiattone, Carlos
Moskowitz, Alison
Spina, Michele
Biasoli, Irene
Manni, Martina
Federico, Massimo
Institución
Resumen
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.