The Role of High Dose Chemotherapy/Autologous Stem Cell Transplantation for Salvage Treatment for Relapsed Peripheral T Cell Lymphoma.

Although the role of high dose chemotherapy (HDCT) and autologous stem cell transplantation (ASCT) in the treatment of aggressive lymphoma has been established, optimal second line treatment, including high-dose therapy with autologous stem cell support, is not well established in patients with peripheral T cell lymphoma (PTCL). The purpose of this retrospective study was to compare the outcome of salvage chemotherapy only with that of HDCT and ASCT in patients with relapsed disease after having reaching a complete response (CR).

We retrospectively investigated the outcome of salvage treatments for patients with relapsed PTCL who had reached a CR.

Between January 1999 and February 2009, 39 patients (15 peripheral T cell lymphoma; 14 extranodal natural killer/T cell lymphoma; 5 anaplastic large cell lymphoma; and 6 angioimmunoblastic T-cell lymphoma) were identified to be eligible for this analysis in our institution. Among them, 25 were treated with only salvage chemotherapy and 14 were treated with HDCT/ASCT. The salvage chemotherapy regimens were ESHAP given in 52% and DHAP given in 12%. Also the conditioning chemotherapy regimens for autologous stem cell transplantation (ASCT) were ESHAP given in 50% and DHAP given in 14.2%. The median number of chemotherapy regimen was 3. The overall response rate of salvage chemotherapy was 92% with a CR rate of 50%. With median follow-up time of 20.7 months, there were no statistical differences between the two groups in terms of progression-free survival and overall survival (p=0.794, and p=0.390, respectively).

There were no significant differences between the two groups in terms of survival outcome. Therefore, considering the dismal outcome in relapsed PTCL patients even after treated with HDCT/ASCT, incorporation of novel therapeutics into a treatment regimen should be considered.

No relevant conflicts of interest to declare.