Abstract
Background:Patients with peripheral T cell lymphomas (PTCLs) generally have a poor prognosis with conventional chemotherapy. Consolidation with autologous stem cell transplantation is an option for patients with PTCL. However, whether prospective or retrospective studies on the timing of autologous stem cell transplantation remains controversial. We cannot determine whether autologous stem cell transplantation is necessary in patients with PTCL achieving first complete remission (CR1) following induction chemotherapy, especially in patients with low‐risk group. Therefore, we compare prognosis of low‐risk patients who underwent ASCT in CR1 following induction regimens and patients who underwent observation and waiting during CR1.Aims:We compare progression‐free survival of low‐risk patients who underwent ASCT in CR1 following induction regimens and patients who underwent observation and waiting during CR1.Methods:We completed a retrospective analysis for low‐risk PTCL patients who underwent either observation or up‐front ASCT during CR1 in our center between 1/1/2007 and 12/31/2018. In our study, patients with PTCL age ≤65 years(median age, 52 years) and IPI score 0‐1 were included. Histologic subtypes include PTCL not otherwise specified (PTCL‐NOS), angioimmunoblastic T‐cell lymphoma a(AITL) and anaplastic lymphoma kinase‐negative large cell lymphoma (ALK‐negative ALCL). In addition, patients with cutaneous T cell lymphoma and anaplastic lymphoma kinase‐positive large cell lymphoma (ALK‐positive ALCL) were excluded. The probabilities of PFS was calculated by the Kaplan‐Meier method and compared by a log‐rank test. The estimated lymphoma of relapse was calculated using cumulative incidence.Results:In our center, 42 patients met all inclusion and exclusion criteria. And 29 patients underwent observation and waiting in CR1, 13 patients underwent consolidative ASCT. In low‐risk patients of PTCL, with a median follow‐up of 22 months, estimated 2‐year PFS and 5‐year PFS in the observation group were 57.4% and 46.0%, respectively. Among ASCT recipients, the 2‐year and 5‐year PFS were 67.7% and 54.2%, respectively. When considering incidence of disease relapse, the 1‐year cumulative incidence of relapse in the observation and ASCT groups was 20.3% and 32.3%, respectively. However, there were no difference between observation and ASCT groups.Summary/Conclusion:In conclusion, for low‐risk PTCL patients achieving CR1 following induction therapy, consolidative ASCT does not extend progression‐free survival compared to observation. We favor proceeding to observe and wait because of high toxic of hematopoietic stem cell transplantation.image
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