Survival of patients with peripheral T-cell lymphoma after first relapse or progression: spectrum of disease and rare long-term survivors

A number of novel therapies are under investigation in relapsed or refractory peripheral T-cell lymphoma (PTCL); however, their relative impact on outcome is unknown. We examined the survival of patients with PTCL after relapse or progression in the absence of hematopoietic stem-cell transplantation...

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Vydáno v:Journal of clinical oncology Ročník 31; číslo 16; s. 1970
Hlavní autoři: Mak, Vivien, Hamm, Jeremey, Chhanabhai, Mukesh, Shenkier, Tamara, Klasa, Richard, Sehn, Laurie H, Villa, Diego, Gascoyne, Randy D, Connors, Joseph M, Savage, Kerry J
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States 01.06.2013
Témata:
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Disease Progression
Disease-Free Survival
Female
Humans
Lymphoma, T-Cell, Peripheral - drug therapy
Lymphoma, T-Cell, Peripheral - mortality
Lymphoma, T-Cell, Peripheral - pathology
Lymphoma, T-Cell, Peripheral - therapy
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Recurrence
Survival Analysis
ISSN:1527-7755, 1527-7755
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Shrnutí:A number of novel therapies are under investigation in relapsed or refractory peripheral T-cell lymphoma (PTCL); however, their relative impact on outcome is unknown. We examined the survival of patients with PTCL after relapse or progression in the absence of hematopoietic stem-cell transplantation and explored factors influencing survival. The three most common subtypes encountered in North America were evaluated: PTCL not otherwise specified (PTCL-NOS), angioimmunoblastic T-cell lymphoma (AITL), and anaplastic large-cell lymphoma (ALCL; anaplastic lymphoma kinase [ALK] positive and ALK negative. After exclusions, 153 patients were analyzed (PTCL-NOS, n = 79 [52%]; AITL, n = 38 [25%]; ALK-positive ALCL, n = 11 [7%]; ALK-negative ALCL, n = 27 [16%; including ALK status unknown, n = 1]). Median time from initial diagnosis to relapse or progression after primary therapy was 6.7 months, and median age at relapse was 66 years (ALK-positive ALCL, 39 years). Median overall survival (OS) and median progression-free survival (PFS) after relapse or progression (second PFS) were 5.5 and 3.1 months, respectively, and were only marginally better in patients who received chemotherapy at relapse (n = 89 [58%]; 6.5 and 3.7 months, respectively). Patients with good performance status (PS) of 0 or 1 (n = 47) at relapse who received chemotherapy had a more favorable OS (P < .001; median OS, 13.7 months) and PFS (P = .006; median second PFS, 5.0 months), which remained significant in multivariate analysis (OS: hazard ratio [HR], 2.09; P = .002; second PFS: HR, 1.66; P = .030). Most patients with relapsed or refractory PTCL have poor outcomes with short survival. Select patients with good PS have more favorable outcomes with standard chemotherapy.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1527-7755
1527-7755
DOI:10.1200/JCO.2012.44.7524