Abstract
Introduction: There is non consensus today for the treatment of PTCL. The five years OS with the CHOP regimen is estimated to 40%. A five years OS of 65% have been expected with an alternating VIP/ABVD regimen in a cohort ot 58 patients (pts) retrospectively studied by the same institution in Grenoble FRANCE (results presented at the french haematology society in 2000).
Aim of the study and methods: To confirm the superiority of the VIP/ABVD in first line for pts with PTCL. We have compared the 2 years EFS of pts receiving 8x CHOP21 or 6 alternating VIP/ABVD in a random manner. The VIP/ABVD regimen consisted of an alternance of three VIP regimen (VP16 100 mg/sqm D1 to D3; Ifosfamide 1000 mg/sqm D1 to D5 and Cisplatinum 20 mg/sqm D1 to D5) and three ABVD (Adriblastin 50 mg/sqm, Bleomycin 10 mg/sqm, Vinblastin 10 mg/sqm and Deticene 375 mg/sqm D1 and D14). A 40 grays IF irradiation was systematically used for AA stage I-II and on the tumoral sites larger than 5 cm to complete the treatment plan.
Results: 100 pts were included and 88 retained after a centralized pathologic review. 57 pts were diagnosed as PTCLu, 15 LAI, 10 T and 4 NTNB anaplasic, 1 angiocentric and 1 NK type. 45 pts received the CHOP and 43 the VIP/ABVD.
53/88 pts (60%) achieved a CR (34) or PR>75% (19). With a median Fup of 26.5 months EFS and OS are respectively 40% at 2 years and 40% at 4 y. There is no difference between the two groups. Two factors but not the IPI score have significantly influenced the survivals: histologic types (anaplasic vs no anaplasic) and AA stage (I–II vs III–IV).
Conclusion: The VIP/ABVD is not superior to the CHOP regimen for the treatment of PTCL. The combination Ann Arbor stage and the histologic pattern is the best predictive factor of the survivals. New innovative approach are mandatory to improve the prognostic of PTCL.
Disclosure: No relevant conflicts of interest to declare.
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