Two studies published in the Annals of Oncology suggest that autologous stem cell transplantation plays a major role in the treatment of patients with T-cell lymphomas.

T-cell lymphomas are a relatively uncommon form of non-Hodgkin’s lymphoma (NHL) that in general responds less well to treatment than B-cell NHL. And while patients with B-cell lymphomas have benefited significantly from Rituxan® (rituximab) therapy over the past decade there is no comparable T-cell antibody for treatment of T-cell lymphomas.

Peripheral T-cell lymphomas are also an uncommon form of NHL that can involve the skin. Patients with peripheral T-cell lymphoma are usually treated with the same drug combinations as B-cell NHL patients but with worse results. The reported 5-year disease-free survivals are in the 20-25% range with overall survivals in the 40-50% range (see related news). A previous multi-center study from Spain reported that over half the patients with peripheral PTCL receiving high-dose chemotherapy (HDC) with autologous stem cell support become long-term disease-free survivors. Results were even better for the subgroup transplanted in first complete remission where disease-free survival at 5 years was 79% (see related news). In the present study these same researchers report the outcomes of 74 patients with peripheral T-cell lymphomas who received HDC with autologous stem cell support while in first complete remission.[1] The median age of this group was 46 years and almost 90% had stage III-IV disease. With a median follow-up of 67 months the 5 year progression-free survival was 63% and the overall survival was 68%. Decreased survival was related to increasing number of adverse risk factors. These authors stated that these data supported the concept that HDC with autologous stem cell support as consolidation therapy was of benefit. However, they were able to identify 14% of patients who did not benefit based on risk factors in the adjusted-International Prognostic Index.

The second study looked at outcomes of 34 adult patients with T-cell lymphoblastic lymphoma.[2] Six patients in this study received conventional therapy, 4 received an allogeneic stem cell transplant and 25 received an autologous stem cell transplant after a chemotherapy response to induction. The 4-year survival of patients receiving a transplant was 79%. All 4 patients who received an allogeneic stem cell transplant are alive and disease-free. For patients receiving an autologous stem cell transplant the 4 year event-free survival was 69%. These authors concluded that patients who responded to induction therapy and received an autologous or allogeneic stem cell transplant had a favorable outcome.

Comments: These data suggest that autologous and possibly allogeneic stem cell transplantation offers a curative approach to the treatment of T-cell lymphomas.

Related News

High-Dose Chemotherapy and Autologous Stem Cell Transplantation Effective for T-Cell Lymphoma (11/26/2003)

Allogeneic Stem Cell Transplants Effective for Refractory Cutaneous T-Cell Lymphomas (9/6/2005)

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