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The outcome of peripheral T-cell lymphoma patients failing first line therapy: a report from the prospective, international T-Cell project.

The outcome of peripheral T-cell lymphoma patients failing first line therapy: a report from the prospective, international T-Cell project.
Author Information (click to view)

Bellei M, Foss FM, Shustov AR, Horwitz SM, Marcheselli L, Kim WS, Cabrera ME, Dlouhy I, Nagler A, Advani RH, Pesce EA, Ko YH, Martinez V, Montoto S, Chiattone C, Moskowitz A, Spina M, Biasoli I, Manni M, Federico M,


Bellei M, Foss FM, Shustov AR, Horwitz SM, Marcheselli L, Kim WS, Cabrera ME, Dlouhy I, Nagler A, Advani RH, Pesce EA, Ko YH, Martinez V, Montoto S, Chiattone C, Moskowitz A, Spina M, Biasoli I, Manni M, Federico M, (click to view)

Bellei M, Foss FM, Shustov AR, Horwitz SM, Marcheselli L, Kim WS, Cabrera ME, Dlouhy I, Nagler A, Advani RH, Pesce EA, Ko YH, Martinez V, Montoto S, Chiattone C, Moskowitz A, Spina M, Biasoli I, Manni M, Federico M,

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Haematologica 2018 03 29() pii 10.3324/haematol.2017.186577

Abstract
PURPOSE
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.

METHODS
We analyzed data from 1,020 patients with newly diagnosed disease, enrolled between September 2006 and December 2015.

RESULTS
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) from documentation of refractory/relapse disease, 440 patients had died. The median overall survival was 5.8 months, and the rates of 3-yr overall survival were 21% and 28% for refractory and relapsed patients, respectively (p<0.001). Patients receiving or not salvage bone marrow transplantation had a 3-yr survival rates 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. CONCLUSION
This study accurately reflects outcomes for patients treated according to standards of care world-wide. Results confirm that peripheral T-cell lymphomas patients had dismal outcome after relapse or progression. Patients with chemotherapy sensitive disease who relapsed > 12 months might benefit from consolidative bone marrow transplantation.

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