Stem cell transplant effective against peripheral T-cell lymphomas

NEW YORK (Reuters Health) - Myeloablative therapy and autologous stem-cell transplantation may offer an effective strategy for the treatment of patients with peripheral T-cell lymphomas (PTCLs), German researchers report in an advance on-line publication in the Journal of Clinical Oncology.

"Early -- upfront - high-dose therapy with support of autologous stem cells is a promising approach for the rare and aggressive group of PTCLs," lead investigator Dr. Peter Reimer told Reuters Health.

Dr. Reimer of Wurzburg University Clinic and colleagues note that conventional chemotherapy leads to poor outcomes in these patients and no standard therapy for most PTCLs has yet been defined.

To investigate further, the researchers enrolled 83 PTCL patients who underwent 4 to 6 cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone. The patients who achieved complete or partial remission underwent myeloablative chemoradiation therapy and stem-cell transplantation.

Mainly because of progressive disease, only 55 of the 83 patients underwent autologous stem-cell transplant. At last follow-up, 23 of the 28 of the patients who did not undergo transplant had died.

After autologous stem-cell transplant, 48 of 55 patients had a complete response and 7 had a partial response. This gave an overall response rate in intention-to-treat analysis of 66%.

The estimated 3-year survival rate was 71% in patients who underwent autologous stem-cell transplant, compared with only 11% in patients who did not.

Despite these promising results, Dr. Reimer concludes that "the impact of this strategy can only be determined by a randomized trial that has to be done in cooperation with many other centers."

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