Long-Term Remissions in Patients with Peripheral T-Cell Lymphoma Following High-Dose Chemotherapy, Autologous Stem Cell Transplantation (ASCT) and Subsequent Radiotherapy

Abstract

Purpose: The prognosis of patients with peripheral T-cell lymphoma and missing complete remission or relapsing before ASCT is assessed to be unfavourable. The aim of this study is to contribute data to the open question, whether additional radiotherapy improves the outcome. Patients and Methods: Forty-eight patients with peripheral T-cell-lymphoma were treated in our institution with high-dose therapy (usually BEAM protocol) and ASCT (age median 54 years, range 19-77). Twenty-five patients received ASCT in first treatment line, 13 in second line, 10 in third line (all refractory to 2nd-line salvage therapy). Seven of these 48 patients received radiotherapy (36-40 Gy, median 36) after ASCT. Results: Five-year overall survival (OS) and progression-free survival (PFS) after 1st-line ASCT and 2nd-line ASCT were 59% and 50%, respectively, and after 3rd-line ASCT significantly lower with 30% and 30%, respectively. Twenty-one patients achieved a sustained complete remission of 2.7 - 22.7 years (median 5.8). No patient relapsed after radiotherapy. Conclusion: Sustained long-term remissions can be achieved in patients with peripheral T-cell lymphoma following ASCT in first, second or third treatment line. Early irradiation after ASCT can possibly consolidate remission in localized residual or refractory disease.