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Zinzani PL, Venturini F, Stefoni V, Fina M, Pellegrini C, Derenzini E, Gandolfi L, Broccoli A, Argnani L, Quirini F, Pileri S, Baccarani M. Gemcitabine as single agent in pretreated T-cell lymphoma patients: evaluation of the long-term outcome. Ann Oncol 2009; 21:860-863. [PMID: 19887465 DOI: 10.1093/annonc/mdp508] [Citation(s) in RCA: 140] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Peripheral T-cell lymphoma unspecified (PTCLU) and mycosis fungoides (MF) often show resistance to conventional chemotherapy. Gemcitabine should be considered a suitable option. We report the long-term update of 39 pretreated T-cell lymphoma patients treated with gemcitabine. PATIENTS AND METHODS From May 1997 to September 2007, 39 pretreated MF and PTCLU patients received gemcitabine. Inclusion criteria were as follows: histologic diagnosis of MF or PTCLU; relapsed/refractory disease; age > or =18 years; and World Health Organization performance status of two or less. Nineteen patients had MF and 20 PTCLU. All patients with MF had a T3-T4, N0, and M0 disease and patients with PTCLU had stage III-IV disease. Gemcitabine was given on days 1, 8, and 15 on a 28-day schedule (1200 mg/m(2)/day) for a total of three to six cycles. RESULTS Overall response rate was 51% (20 of 39 patients); complete response (CR) and partial response (PR) rates were 23% (9 of 39 patients) and 28% (11 of 39 patients), respectively. Patients with MF had a CR rate of 16% and a PR rate of 32% compared with a CR rate of 30% and a PR rate of 25% of PTCLU patients. Among the CR patients, 7 of 9 are in continuous complete response with a variable disease-free interval (15-120 months). CONCLUSION In our experience, gemcitabine proved to be effective in pretreated MF and PTCLU patients, even in the long term.
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Affiliation(s)
- P L Zinzani
- Institute of Hematology and Medical Oncology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy.
| | - F Venturini
- Institute of Hematology and Medical Oncology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy
| | - V Stefoni
- Institute of Hematology and Medical Oncology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy
| | - M Fina
- Institute of Hematology and Medical Oncology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy
| | - C Pellegrini
- Institute of Hematology and Medical Oncology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy
| | - E Derenzini
- Institute of Hematology and Medical Oncology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy
| | - L Gandolfi
- Institute of Hematology and Medical Oncology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy
| | - A Broccoli
- Institute of Hematology and Medical Oncology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy
| | - L Argnani
- Institute of Hematology and Medical Oncology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy
| | - F Quirini
- Institute of Hematology and Medical Oncology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy
| | - S Pileri
- Institute of Hematology and Medical Oncology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy
| | - M Baccarani
- Institute of Hematology and Medical Oncology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy
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Kyriakou C, Canals C, Goldstone A, Caballero D, Metzner B, Kobbe G, Kolb HJ, Kienast J, Reimer P, Finke J, Oberg G, Hunter A, Theorin N, Sureda A, Schmitz N. High-Dose Therapy and Autologous Stem-Cell Transplantation in Angioimmunoblastic Lymphoma: Complete Remission at Transplantation Is the Major Determinant of Outcome—Lymphoma Working Party of the European Group for Blood and Marrow Transplantation. J Clin Oncol 2008; 26:218-24. [DOI: 10.1200/jco.2008.12.6219] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PurposePatients with angioimmunoblastic T-cell lymphoma (AITL) have poor prognoses with current conventional chemotherapy. The aim of this study was to evaluate the effect of high-dose therapy (HDT) followed by autologous stem-cell transplantation (ASCT) on patients with AITL.Patients and MethodsWe report a retrospective, multicenter study of 146 patients with AITL who received ASCT. The source of the stem cells was peripheral blood in 143 patients. The conditioning regimen varied, and 74% of the patients received carmustine and 1,3-bis(2-chloroethyl)-1-nitrosourea; etoposide; ara-C; and melphalan chemotherapy.ResultsAfter a median follow-up of 31 months (range, 3 to 174 months), 95 patients (65%) remained alive, and 51 patients (35%) died. Forty-two patients died as a result of disease progression, and nine died as a result of regimen-related toxicity. The cumulative incidence of nonrelapse mortality was 5% and 7% at 12 and 24 months, respectively. The actuarial overall survival (OS) was 67% at 24 months and 59% at 48 months. The cumulative incidence of relapse was estimated at 40% and 51% at 24 and 48 months, respectively. Disease status at transplantation was the major factor that impacted outcome. Patients who received a transplant during first complete remission (CR) had significantly superior progression-free survival and OS. The estimated PFS rates for patients who received their transplants in CR were 70% and 56% at 24 and 48 months, respectively; 42% and 30% for patients with chemotherapy-sensitive disease at those time points, respectively; and 23% at both time points for patients with chemotherapy-refractory disease.ConclusionThis study shows that HDT and ASCT offers the possibility of long-term disease-free survival to patients with AITL. Early transplantation is necessary to achieve optimal results.
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Affiliation(s)
- Charalampia Kyriakou
- From the University College London; European Bone Marrow Transplantation Group, London; and Leicester Royal Infirmary, Leicester, United Kingdom; Hospital Clínico Servicio de Hematología, Salamanca; and Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; University Hospital, Dept. of Hematology; and University Hospital, Department of Medicine, Uppsala, Sweden; University of Freiburg, Department of Medicine -Hematology, Oncology, Freiburg; Medical Klinik, Wurzburg; University of Münster, Department of
| | - Carmen Canals
- From the University College London; European Bone Marrow Transplantation Group, London; and Leicester Royal Infirmary, Leicester, United Kingdom; Hospital Clínico Servicio de Hematología, Salamanca; and Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; University Hospital, Dept. of Hematology; and University Hospital, Department of Medicine, Uppsala, Sweden; University of Freiburg, Department of Medicine -Hematology, Oncology, Freiburg; Medical Klinik, Wurzburg; University of Münster, Department of
| | - Anthony Goldstone
- From the University College London; European Bone Marrow Transplantation Group, London; and Leicester Royal Infirmary, Leicester, United Kingdom; Hospital Clínico Servicio de Hematología, Salamanca; and Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; University Hospital, Dept. of Hematology; and University Hospital, Department of Medicine, Uppsala, Sweden; University of Freiburg, Department of Medicine -Hematology, Oncology, Freiburg; Medical Klinik, Wurzburg; University of Münster, Department of
| | - Dolores Caballero
- From the University College London; European Bone Marrow Transplantation Group, London; and Leicester Royal Infirmary, Leicester, United Kingdom; Hospital Clínico Servicio de Hematología, Salamanca; and Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; University Hospital, Dept. of Hematology; and University Hospital, Department of Medicine, Uppsala, Sweden; University of Freiburg, Department of Medicine -Hematology, Oncology, Freiburg; Medical Klinik, Wurzburg; University of Münster, Department of
| | - Bernd Metzner
- From the University College London; European Bone Marrow Transplantation Group, London; and Leicester Royal Infirmary, Leicester, United Kingdom; Hospital Clínico Servicio de Hematología, Salamanca; and Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; University Hospital, Dept. of Hematology; and University Hospital, Department of Medicine, Uppsala, Sweden; University of Freiburg, Department of Medicine -Hematology, Oncology, Freiburg; Medical Klinik, Wurzburg; University of Münster, Department of
| | - Guido Kobbe
- From the University College London; European Bone Marrow Transplantation Group, London; and Leicester Royal Infirmary, Leicester, United Kingdom; Hospital Clínico Servicio de Hematología, Salamanca; and Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; University Hospital, Dept. of Hematology; and University Hospital, Department of Medicine, Uppsala, Sweden; University of Freiburg, Department of Medicine -Hematology, Oncology, Freiburg; Medical Klinik, Wurzburg; University of Münster, Department of
| | - Hans-Jochem Kolb
- From the University College London; European Bone Marrow Transplantation Group, London; and Leicester Royal Infirmary, Leicester, United Kingdom; Hospital Clínico Servicio de Hematología, Salamanca; and Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; University Hospital, Dept. of Hematology; and University Hospital, Department of Medicine, Uppsala, Sweden; University of Freiburg, Department of Medicine -Hematology, Oncology, Freiburg; Medical Klinik, Wurzburg; University of Münster, Department of
| | - Joachim Kienast
- From the University College London; European Bone Marrow Transplantation Group, London; and Leicester Royal Infirmary, Leicester, United Kingdom; Hospital Clínico Servicio de Hematología, Salamanca; and Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; University Hospital, Dept. of Hematology; and University Hospital, Department of Medicine, Uppsala, Sweden; University of Freiburg, Department of Medicine -Hematology, Oncology, Freiburg; Medical Klinik, Wurzburg; University of Münster, Department of
| | - Peter Reimer
- From the University College London; European Bone Marrow Transplantation Group, London; and Leicester Royal Infirmary, Leicester, United Kingdom; Hospital Clínico Servicio de Hematología, Salamanca; and Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; University Hospital, Dept. of Hematology; and University Hospital, Department of Medicine, Uppsala, Sweden; University of Freiburg, Department of Medicine -Hematology, Oncology, Freiburg; Medical Klinik, Wurzburg; University of Münster, Department of
| | - Jurgen Finke
- From the University College London; European Bone Marrow Transplantation Group, London; and Leicester Royal Infirmary, Leicester, United Kingdom; Hospital Clínico Servicio de Hematología, Salamanca; and Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; University Hospital, Dept. of Hematology; and University Hospital, Department of Medicine, Uppsala, Sweden; University of Freiburg, Department of Medicine -Hematology, Oncology, Freiburg; Medical Klinik, Wurzburg; University of Münster, Department of
| | - Gunnar Oberg
- From the University College London; European Bone Marrow Transplantation Group, London; and Leicester Royal Infirmary, Leicester, United Kingdom; Hospital Clínico Servicio de Hematología, Salamanca; and Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; University Hospital, Dept. of Hematology; and University Hospital, Department of Medicine, Uppsala, Sweden; University of Freiburg, Department of Medicine -Hematology, Oncology, Freiburg; Medical Klinik, Wurzburg; University of Münster, Department of
| | - Ann Hunter
- From the University College London; European Bone Marrow Transplantation Group, London; and Leicester Royal Infirmary, Leicester, United Kingdom; Hospital Clínico Servicio de Hematología, Salamanca; and Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; University Hospital, Dept. of Hematology; and University Hospital, Department of Medicine, Uppsala, Sweden; University of Freiburg, Department of Medicine -Hematology, Oncology, Freiburg; Medical Klinik, Wurzburg; University of Münster, Department of
| | - Niklas Theorin
- From the University College London; European Bone Marrow Transplantation Group, London; and Leicester Royal Infirmary, Leicester, United Kingdom; Hospital Clínico Servicio de Hematología, Salamanca; and Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; University Hospital, Dept. of Hematology; and University Hospital, Department of Medicine, Uppsala, Sweden; University of Freiburg, Department of Medicine -Hematology, Oncology, Freiburg; Medical Klinik, Wurzburg; University of Münster, Department of
| | - Anna Sureda
- From the University College London; European Bone Marrow Transplantation Group, London; and Leicester Royal Infirmary, Leicester, United Kingdom; Hospital Clínico Servicio de Hematología, Salamanca; and Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; University Hospital, Dept. of Hematology; and University Hospital, Department of Medicine, Uppsala, Sweden; University of Freiburg, Department of Medicine -Hematology, Oncology, Freiburg; Medical Klinik, Wurzburg; University of Münster, Department of
| | - Norbert Schmitz
- From the University College London; European Bone Marrow Transplantation Group, London; and Leicester Royal Infirmary, Leicester, United Kingdom; Hospital Clínico Servicio de Hematología, Salamanca; and Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; University Hospital, Dept. of Hematology; and University Hospital, Department of Medicine, Uppsala, Sweden; University of Freiburg, Department of Medicine -Hematology, Oncology, Freiburg; Medical Klinik, Wurzburg; University of Münster, Department of
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