The outcome of peripheral T-cell lymphoma patients failing first-line therapy: a report from the prospective, International T-Cell Project
Author
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Bellei, Mónica
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Foss, Francine M.
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Shustov, Andrei
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Horwitz, Steven M.
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Marcheselli, Luigi
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Kim, Won Seog
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Cabrera, María Elena
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Dlouhy, Iván
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Nagler, Arnon
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Advani, Ranjana H.
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Pesce, Emanuela Anna
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Ko, Young-Hyeh
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Martínez, Virginia
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Montoto, Silvia
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Chiattone, Carlos
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Moskowitz, Alison
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Spina, Michele
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Biasoli, Irene
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Manni, Martina
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Federico, Massimo
Admission date
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2018-12-27T19:39:34Z
Available date
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2018-12-27T19:39:34Z
Publication date
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2018-07-03
Cita de ítem
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Haematologica, 103(7), 03 julio 2018, 1191-1197 pp.
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Identifier
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0390-6078
Identifier
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10.3324/haematol.2017.186577
Identifier
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https://repositorio.uchile.cl/handle/2250/159232
Abstract
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This analysis explored factors influencing survival of patients with primary refractory and relapsed peripheral T-cell lymphomas enrolled in the prospective International T-cell Project. We analyzed data from 1020 patients with newly diagnosed disease, enrolled between September 2006 and December 2015. Out of 937 patients who received first-line treatment, 436 (47%) were identified as refractory and 197 (21%) as relapsed. Median time from the end of treatment to relapse was 8 months (range 2-73). Overall, 75 patients (8%) were consolidated with bone marrow transplantation, including 12 refractory and 22 relapsed patients. After a median follow up of 38 months (range 1-96 months) from documentation of refractory/relapsed disease, 440 patients had died. The median overall survival (OS) was 5.8 months; 3-year overall survival rates were 21% and 28% for refractory and relapsed patients, respectively (P<0.001). Patients receiving or not salvage bone marrow transplantation had a 3-year survival of 48% and 18%, respectively (P<0.001). In a univariate Cox regression analysis, refractory disease was associated with a higher risk of death (HR=1.43, P=0.001), whereas late relapse (>12 months, HR 0.57, P=0.001) and salvage therapy with transplantation (HR=0.36, P<0.001) were associated with a better OS. No difference was found in OS with respect to histology. This study accurately reflects outcomes for patients treated according to standards of care worldwide. Results confirm that peripheral T-cell lymphomas patients had dismal outcome after relapse or progression. Patients with chemotherapy sensitive disease who relapsed after more than 12 months might benefit from consolidation bone marrow transplantation.
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Patrocinador
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Fondazione Cassa di Risparmio di Modena, Modena, Italy;
Associazione Angela Serra per la Ricerca sul Cancro, Modena, Italy;
Fondazione Italiana Linfomi (FIL), Alessandria, Italy;
Allos Therapeutics, Inc., Westminster, CO, USA;
AIRC (Associazione Italiana per la Ricerca sul Cancro) 5x1000: 10007;
NIH/NCI CCSG: P30 CA008748;
Spectrum Pharmaceuticals Inc., Henderson, NV, USA.