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Nakamura N, Kanemura N, Matsumoto T, Nakamura H, Ikoma Y, Shibata Y, Kitagawa J, Kasahara S, Yamada T, Sawada M, Kaneda Y, Fukuno K, Takada E, Goto H, Lee S, Fujita K, Morishita T, Hara T, Tsurumi H, Shimizu M. Comparison of the prognostic impact of IPI and PIT in peripheral T-cell lymphoma in real-world practice with a large elderly population. Sci Rep 2023; 13:19060. [PMID: 37925551 PMCID: PMC10625631 DOI: 10.1038/s41598-023-46501-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 11/01/2023] [Indexed: 11/06/2023] Open
Abstract
We compared the predictive ability of the International Prognostic Index (IPI), a frequently used prognostic model for peripheral T-cell lymphoma (PTCL), with that of a type-specific prognostic model, the Prognostic Index for PTCL-U (PIT). We retrospectively analyzed 113 patients diagnosed with PTCL. The median age was 67 years (range, 16-88 years), 75 patients (66%) were male, and the most common disease type was PTCL, not otherwise specified (69%). With a median follow-up of 6.8 years (interquartile range, 2.7-9.9 years), 5-year survival rates for the four groups in IPI were 85%, 62%, 49%, and 13%, respectively. Similarly, 5-year survival rates for the four groups in PIT were 83%, 64%, 49%, and 19%, respectively. The area under the receiving operating characteristic curve for predicting mortality from PIT (0.725) was not significantly different from that from the IPI (0.685, P = 0.134). Multivariable analysis showed that performance status ≥ 2 (P < 0.0001) and extranodal lesions ≥ 2 (P = 0.029) were significantly associated with lower overall survival. The present study found no significant difference in prognostic ability between the IPI and PIT for PTCL, and both models appear useful as predictive models.
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Affiliation(s)
- Nobuhiko Nakamura
- Department of Hematology and Infectious Disease, Gifu University Hospital, Gifu, Japan.
| | - Nobuhiro Kanemura
- Department of Hematology and Infectious Disease, Gifu University Hospital, Gifu, Japan
| | - Takuro Matsumoto
- Department of Hematology and Infectious Disease, Gifu University Hospital, Gifu, Japan
| | - Hiroshi Nakamura
- Department of Hematology and Infectious Disease, Gifu University Hospital, Gifu, Japan
| | - Yoshikazu Ikoma
- Department of Hematology and Infectious Disease, Gifu University Hospital, Gifu, Japan
- Department of Hematology, Gifu Municipal Hospital, Gifu, Japan
| | - Yuhei Shibata
- Department of Hematology, Gifu Municipal Hospital, Gifu, Japan
| | | | - Senji Kasahara
- Department of Hematology, Gifu Municipal Hospital, Gifu, Japan
| | - Toshiki Yamada
- Department of Hematology, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Michio Sawada
- Department of Hematology, Gifu Red Cross Hospital, Gifu, Japan
| | - Yuto Kaneda
- Department of Hematology and Infectious Disease, Gifu University Hospital, Gifu, Japan
- Department of Hematology, Takayama Red Cross Hospital, Takayama, Japan
| | - Kenji Fukuno
- Department of Hematology, Takayama Red Cross Hospital, Takayama, Japan
| | - Eri Takada
- Department of Hematology, Gihoku Kosei Hospital, Yamagata, Japan
| | - Hideko Goto
- Department of Hematology, Chuno Kosei Hospital, Seki, Japan
| | - Shin Lee
- Department of Hematology, Matsunami General Hospital, Gifu, Japan
| | - Kei Fujita
- Department of Hematology, Matsunami General Hospital, Gifu, Japan
| | | | - Takeshi Hara
- Department of Hematology, Matsunami General Hospital, Gifu, Japan
| | - Hisashi Tsurumi
- Department of Hematology and Infectious Disease, Gifu University Hospital, Gifu, Japan
- Department of Hematology, Matsunami General Hospital, Gifu, Japan
| | - Masahito Shimizu
- Department of Hematology and Infectious Disease, Gifu University Hospital, Gifu, Japan
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2
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Kim WS, Fukuhara N, Yoon DH, Yamamoto K, Uchida T, Negoro E, Izutsu K, Terui Y, Nakajima H, Ando K, Suehiro Y, Kang HJ, Ko PS, Nagahama F, Sonehara Y, Nagai H, Tien HF, Kwong YL, Tobinai K. Darinaparsin in patients with relapsed or refractory peripheral T-cell lymphoma: results of an Asian phase 2 study. Blood Adv 2023; 7:4903-4912. [PMID: 36661315 PMCID: PMC10463191 DOI: 10.1182/bloodadvances.2022008615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 12/12/2022] [Accepted: 01/20/2023] [Indexed: 01/21/2023] Open
Abstract
Darinaparsin is a novel organic arsenical compound of dimethylated arsenic conjugated to glutathione, with antitumor activity and a mechanism of action markedly different from other available agents. This phase 2, nonrandomized, single-arm, open-label study evaluated the efficacy and safety of intravenous darinaparsin (300 mg/m2 over 1 hour, once daily for 5 consecutive days, per 21-day cycle) and its pharmacokinetics at multiple doses in 65 Asian patients with relapsed or refractory peripheral T-cell lymphoma (PTCL). The primary end point was the overall response rate (ORR). The ORR based on central assessment was 19.3% (90% confidence interval, 11.2-29.9), which was significantly higher than the predefined threshold of 10% (P = .024). The ORR was 16.2% in patients with PTCL-not otherwise specified and 29.4% in patients with angioimmunoblastic T-cell lymphoma. Tumor size decreased in 62.3% of patients. Treatment-emergent adverse events (TEAEs) were observed in 98.5% of patients. Grade ≥3 TEAEs with an incidence rate of ≥5% included anemia (15.4%), thrombocytopenia (13.8%), neutropenia (12.3%), leukopenia (9.2%), lymphopenia (9.2%), and hypertension (6.2%). Darinaparsin is effective and well tolerated, with TEAEs that were clinically acceptable and manageable with symptomatic treatment and dose reductions. This trial was registered at www.clinicaltrials.gov as #NCT02653976.
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Affiliation(s)
- Won-Seog Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | | | - Dok-Hyun Yoon
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | | | - Toshiki Uchida
- Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan
| | | | - Koji Izutsu
- National Cancer Center Hospital, Tokyo, Japan
| | - Yasuhito Terui
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | | | | | - Youko Suehiro
- National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | | | - Po-Shen Ko
- Taipei Veterans General Hospital, Taipei, Taiwan
| | | | | | - Hirokazu Nagai
- National Hospital Organization Nagoya Medical Center, Nagoya, Japan
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Macapagal SC, Bennani NN. Nodal peripheral T-cell lymphoma: Chemotherapy-free management, are we there yet? Blood Rev 2023; 60:101071. [PMID: 36898933 DOI: 10.1016/j.blre.2023.101071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/24/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023]
Abstract
Peripheral T-cell lymphomas (PTCLs) are a diverse and uncommon type of lymphoid malignancies with a dismal prognosis. Recent advances in genomic studies have shown recurring mutations that are changing our knowledge of the disease's molecular genetics and pathogenesis. As such, new targeted therapies and treatments to improve disease outcomes are currently being explored. In this review, we discussed the current understanding of the nodal PTCL biology with potential therapeutic implications and gave our insights on the promising novel therapies that are currently under study such as immunotherapy, chimeric antigen receptor T-cell therapy, and oncolytic virotherapy.
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Affiliation(s)
| | - N Nora Bennani
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
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4
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Yap DRY, Lim JQ, Huang D, Ong CK, Chan JY. Emerging predictive biomarkers for novel therapeutics in peripheral T-cell and natural killer/T-cell lymphoma. Front Immunol 2023; 14:1068662. [PMID: 36776886 PMCID: PMC9909478 DOI: 10.3389/fimmu.2023.1068662] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/09/2023] [Indexed: 01/27/2023] Open
Abstract
Peripheral T-cell lymphoma (PTCL) and natural killer/T-cell lymphoma (NKTCL) are rare subtypes of non-Hodgkin's lymphoma that are typically associated with poor treatment outcomes. Contemporary first-line treatment strategies generally involve the use of combination chemoimmunotherapy, radiation and/or stem cell transplant. Salvage options incorporate a number of novel agents including epigenetic therapies (e.g. HDAC inhibitors, DNMT inhibitors) as well as immune checkpoint inhibitors. However, validated biomarkers to select patients for individualized precision therapy are presently lacking, resulting in high treatment failure rates, unnecessary exposure to drug toxicities, and missed treatment opportunities. Recent advances in research on the tumor and microenvironmental factors of PTCL and NKTCL, including alterations in specific molecular features and immune signatures, have improved our understanding of these diseases, though several issues continue to impede progress in clinical translation. In this Review, we summarize the progress and development of the current predictive biomarker landscape, highlight potential knowledge gaps, and discuss the implications on novel therapeutics development in PTCL and NKTCL.
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Affiliation(s)
- Daniel Ren Yi Yap
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Jing Quan Lim
- Lymphoma Genomic Translational Research Laboratory, Division of Cellular and Molecular Research, National Cancer Centre Singapore, Singapore, Singapore
| | - Dachuan Huang
- Lymphoma Genomic Translational Research Laboratory, Division of Cellular and Molecular Research, National Cancer Centre Singapore, Singapore, Singapore
| | - Choon Kiat Ong
- Lymphoma Genomic Translational Research Laboratory, Division of Cellular and Molecular Research, National Cancer Centre Singapore, Singapore, Singapore
| | - Jason Yongsheng Chan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
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5
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Wu MM, Fu WJ, Wu J, Zhu LL, Niu T, Yang R, Yao J, Lu Q, Liao XY. Noncirrhotic portal hypertension due to peripheral T-cell lymphoma, not otherwise specified: A case report. World J Clin Cases 2022; 10:9417-9427. [PMID: 36159409 PMCID: PMC9477668 DOI: 10.12998/wjcc.v10.i26.9417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/20/2022] [Accepted: 08/05/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Peripheral T-cell lymphoma (PTCL), an aggressive and rare disease that belongs to a heterogeneous group of mature T-cell lymphomas, develops rapidly and has a poor prognosis. Early detection and treatment are essential to improve patient cure and survival rates. Here, we report a rare case of PTCL with clinical presentation of noncirrhotic portal hypertension, which provides a basis for early vigilance of lymphomas in the future.
CASE SUMMARY A 65-year-old Chinese woman was admitted to our hospital because of abdominal distension for 3 months and pitting oedema of both lower limbs for 2 months. Physical examinations and associated auxiliary examinations showed the presence of hepatosplenomegaly, and her hepatic venous pressure gradient was 10 mmHg. Immunohistochemical analysis of the liver biopsy confirmed the diagnosis of PTCL. The patient underwent combination therapy with dexamethasone, VP-16, and chidamide. Unfortunately, after 41 days of chemotherapy, the patient died of multiple organ failure.
CONCLUSION PCTL accompanied by noncirrhotic portal hypertension is rarely reported. This case report discusses the diagnosis of a patient according to the literature.
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Affiliation(s)
- Miao-Miao Wu
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Wen-Jun Fu
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Jia Wu
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Lin-Lin Zhu
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Ting Niu
- Department of Haematology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Rong Yang
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Jin Yao
- Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Qiang Lu
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xiao-Yang Liao
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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6
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Zhang Y, Chen Q, Lu C, Yu L. Prognostic role of controlling nutritional status score in hematological malignancies. Hematology 2022; 27:653-658. [PMID: 35622088 DOI: 10.1080/16078454.2022.2078040] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Controlling nutritional status (CONUT) score, based on three indexes including serum albumin (ALB), total cholesterol (CHO), and absolute lymphocyte count (ALC), has been closely associated with the prognosis of cancer patients. Multiple studies revealed the significance of CONUT score in hematological malignancies, including diffuse large B-cell lymphoma (DLBCL), peripheral T-cell lymphoma (PTCL), multiple myeloma (MM), and leukemia. OBJECTIVE This review aimed to explore the prognostic role of CONUT score in hematological malignancies. METHODS We conducted this review through Pubmed to summarize the published studies on the CONUT score in hematological malignancies, using the terms: Controlling nutritional status, CONUT score, hematological malignancy, lymphoma, multiple myeloma, and leukemia. RESULT CONUT score can reflect not only the nutritional status but also the inflammatory status of patients with hematological malignancies. It can assist in predicting the survival of patients with DLBCL, PTCL, MM, adult T-cell leukemia (ATL), myelodysplastic syndrome (MDS), and acute myeloid leukemia with myelodysplasia related changes (AML-MRC). CONCLUSION CONUT score plays an important role in predicting the prognosis of patients with hematological malignancies.
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Affiliation(s)
- Yijing Zhang
- Department of Hematology, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, People's Republic of China.,Key Laboratory of Hematology, Nanjing Medical University, Nanjing, People's Republic of China
| | - Qiuni Chen
- Department of Hematology, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, People's Republic of China.,Key Laboratory of Hematology, Nanjing Medical University, Nanjing, People's Republic of China
| | - Chuanyang Lu
- Department of Hematology, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, People's Republic of China.,Key Laboratory of Hematology, Nanjing Medical University, Nanjing, People's Republic of China
| | - Liang Yu
- Department of Hematology, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, People's Republic of China.,Key Laboratory of Hematology, Nanjing Medical University, Nanjing, People's Republic of China
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7
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Nakamura N, Kanemura N, Lee S, Fujita K, Morishita T, Takada E, Shibata Y, Kasahara S, Goto H, Fukuno K, Hara T, Yamada T, Sawada M, Tsurumi H, Shimizu M. Prognostic impact of the controlling nutritional status score in patients with peripheral T-cell lymphoma. Leuk Lymphoma 2021; 63:1323-1330. [PMID: 34965828 DOI: 10.1080/10428194.2021.2020777] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The controlling nutritional status (CONUT) score is a simplified nutritional index calculated from serum albumin, total cholesterol, and total lymphocyte count. This study evaluated the prognostic impact of the CONUT score on overall survival (OS) in patients with peripheral T-cell lymphoma (PTCL). A multicenter, retrospective cohort study including 99 patients with PTCL was conducted. The CONUT score was significantly higher in the non-survivor group (median 5, range 0-12) than in the survivor group (median 3, range 0-11; p = 0.026). The CONUT score was an independent prognostic factor in a multivariable Cox proportional hazards model (hazard ratio 1.119, 95% confidence interval 1.021-1.227, p = 0.017). No significant effect-modification by the International Prognostic Index (IPI) was observed, and the CONUT score affected the prognosis of PTCL regardless of the IPI (P for interaction = 0.208). In conclusion, the CONUT score is an independent prognostic factor for PTCL irrespective of IPI category.
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Affiliation(s)
- Nobuhiko Nakamura
- Department of Hematology and Infectious Disease, Gifu University Hospital, Gifu, Japan
| | - Nobuhiro Kanemura
- Department of Hematology and Infectious Disease, Gifu University Hospital, Gifu, Japan
| | - Shin Lee
- Department of Hematology, Matsunami General Hospital, Gifu, Japan
| | - Kei Fujita
- Department of Hematology, Matsunami General Hospital, Gifu, Japan
| | - Tetsuji Morishita
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Eri Takada
- Department of Hematology, Gihoku Kosei Hospital, Yamagata, Japan
| | - Yuhei Shibata
- Department of Hematology, Gifu Municipal Hospital, Gifu, Japan
| | - Senji Kasahara
- Department of Hematology, Gifu Municipal Hospital, Gifu, Japan
| | - Hideko Goto
- Department of Hematology, Chuno Kosei Hospital, Seki, Japan
| | - Kenji Fukuno
- Department of Hematology, Takayama Red Cross Hospital, Takayama, Japan
| | - Takeshi Hara
- Department of Hematology, Matsunami General Hospital, Gifu, Japan
| | - Toshiki Yamada
- Department of Hematology, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Michio Sawada
- Department of Hematology, Gifu Red Cross Hospital, Gifu, Japan
| | - Hisashi Tsurumi
- Department of Hematology and Infectious Disease, Gifu University Hospital, Gifu, Japan.,Department of Hematology, Matsunami General Hospital, Gifu, Japan
| | - Masahito Shimizu
- Department of Hematology and Infectious Disease, Gifu University Hospital, Gifu, Japan
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8
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Maura F, Dodero A, Carniti C, Bolli N, Magni M, Monti V, Cabras A, Leongamornlert D, Abascal F, Diamond B, Rodriguez-Martin B, Zamora J, Butler A, Martincorena I, Tubio JMC, Campbell PJ, Chiappella A, Pruneri G, Corradini P. CDKN2A deletion is a frequent event associated with poor outcome in patients with peripheral T-cell lymphoma not otherwise specified (PTCL-NOS). Haematologica 2021; 106:2918-2926. [PMID: 33054126 PMCID: PMC8561277 DOI: 10.3324/haematol.2020.262659] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 09/02/2020] [Indexed: 11/23/2022] Open
Abstract
Nodal peripheral T-cell lymphoma not otherwise specified (PTCL-NOS) remains a diagnosis encompassing a heterogenous group of PTCL cases not fitting criteria for more homogeneous subtypes. They are characterized by a poor clinical outcome when treated with anthracycline-containing regimens. A better understanding of their biology could improve prognostic stratification and foster the development of novel therapeutic approaches. Recent targeted and whole exome sequencing studies have shown recurrent copy number abnormalities (CNAs) with prognostic significance. Here, investigating 5 formalin-fixed, paraffin embedded cases of PTCL-NOS by whole genome sequencing (WGS), we found a high prevalence of structural variants and complex events, such as chromothripsis likely responsible for the observed CNAs. Among them, CDKN2A and PTEN deletions emerged as the most frequent aberration, as confirmed in a final cohort of 143 patients with nodal PTCL. The incidence of CDKN2A and PTEN deletions among PTCL-NOS was 46% and 26%, respectively. Furthermore, we found that co-occurrence of CDKN2A and PTEN deletions is an event associated with PTCL-NOS with absolute specificity. In contrast, these deletions were rare and never co-occurred in angioimmunoblastic and anaplastic lymphomas. CDKN2A deletion was associated with shorter overall survival in multivariate analysis corrected by age, IPI, transplant eligibility and GATA3 expression (adjusted HR =2.53; 95% CI 1.006-6.3; p=0.048). These data suggest that CDKN2A deletions may be relevant for refining the prognosis of PTCL-NOS and their significance should be evaluated in prospective trials.
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Affiliation(s)
| | - Anna Dodero
- Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Cristiana Carniti
- Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Niccolò Bolli
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Martina Magni
- Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Valentina Monti
- Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Antonello Cabras
- Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Daniel Leongamornlert
- The Cancer, Aging and Somatic Mutation Program, Wellcome Sanger Institute, Hinxton, Cambridgeshire, UK
| | - Federico Abascal
- The Cancer, Aging and Somatic Mutation Program, Wellcome Sanger Institute, Hinxton, Cambridgeshire, UK
| | - Benjamin Diamond
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Bernardo Rodriguez-Martin
- CIMUS - Molecular Medicine and Chronic Diseases Research Center, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Jorge Zamora
- CIMUS - Molecular Medicine and Chronic Diseases Research Center, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Adam Butler
- The Cancer, Aging and Somatic Mutation Program, Wellcome Sanger Institute, Hinxton, Cambridgeshire, UK
| | - Inigo Martincorena
- The Cancer, Aging and Somatic Mutation Program, Wellcome Sanger Institute, Hinxton, Cambridgeshire, UK
| | - Jose M. C. Tubio
- CIMUS - Molecular Medicine and Chronic Diseases Research Center, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Peter J. Campbell
- The Cancer, Aging and Somatic Mutation Program, Wellcome Sanger Institute, Hinxton, Cambridgeshire, UK
| | - Annalisa Chiappella
- Department of Hematology Azienda Ospedaliera Città della Salute e della Scienza, Turin, Italy
| | - Giancarlo Pruneri
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Paolo Corradini
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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9
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Du J, Yu D, Han X, Zhu L, Huang Z. Comparison of Allogeneic Stem Cell Transplant and Autologous Stem Cell Transplant in Refractory or Relapsed Peripheral T-Cell Lymphoma: A Systematic Review and Meta-analysis. JAMA Netw Open 2021; 4:e219807. [PMID: 34042995 PMCID: PMC8160596 DOI: 10.1001/jamanetworkopen.2021.9807] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
IMPORTANCE Hematopoietic stem cell transplant (HSCT) is an advisable option for refractory or relapsed peripheral T-cell lymphoma (R/R-PTCL), but whether allogeneic HSCT or autologous HSCT is more beneficial is unknown. OBJECTIVE To compare the effectiveness and safety of allogeneic HSCT vs autologous HSCT in patients with R/R-PTCL. DATA SOURCES A systematic search of the PubMed, Embase, the Cochrane Central Register of Controlled Trials, Wanfang, and China National Knowledge Infrastructure databases with the search items refractory or relapsed peripheral T-cell lymphoma, ASCT/autologous stem-cell transplantation, allo-HSCT/allogeneic stem-cell transplantation, therapeutic effect, and treatment was conducted for articles published from January 12, 2001, to October 1, 2020. STUDY SELECTION After duplicate and irrelevant publications were discarded, 329 were ineligible according to the inclusion (clinical trials or retrospective studies with >10 samples) and exclusion criteria (articles without overall survival [OS], progression-free survival [PFS], and transplantation-related mortality [TRM]). Thirty trials were included in the meta-analysis. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. DATA EXTRACTION AND SYNTHESIS Data on study design, individual characteristics, and outcomes were extracted. All statistics were pooled by applying a random-effects model. MAIN OUTCOMES AND MEASURES The prespecified main outcomes were OS, PFS, and TRM. RESULTS Of 6548 articles, data extracted from the 30 studies (including 880 patients who underwent allogeneic HSCT and 885 who underwent autologous HSCT) were included in this meta-analysis. In the allogeneic HSCT group, a 3-year OS of 50% (95% CI, 41%-60%) and PFS of 42% (95% CI, 35%-51%), a 5-year OS of 54% (95% CI, 47%-62%) and PFS of 48% (95% CI, 40%-56%), and a 3-year TRM of 32% (95% CI, 27%-37%) were observed. In the autologous HSCT group, a 3-year OS of 55% (95% CI, 48%-64%) and PFS of 41% (95% CI, 33%-51%), a 5-year OS of 53% (95% CI, 44%-64%) and PFS of 40% (95% CI, 24%-58%), and a 3-year TRM of 7% (95% CI, 2%-23%) were observed. CONCLUSIONS AND RELEVANCE In this systematic review and meta-analysis, OS and PFS were similar in the allogeneic HSCT and autologous HSCT groups; however, allogeneic HSCT was associated with specific survival benefits among patients with R/R-PTCL.
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Affiliation(s)
- Jun Du
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, People's Republic of China
| | - Dandan Yu
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, People's Republic of China
| | - Xinle Han
- Shenzhen PKU-HKUST Medical Center, Shenzhen, People's Republic of China
| | - Lijun Zhu
- Binjiang College of Nanjing University of Information Science & Technology, Jiangsu, People's Republic of China
| | - Zoufang Huang
- Department of Hematology, The First Affiliated Hospital of Gannan Medical University, Jiangxi, People's Republic of China
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