Autologous transplantation as consolidation for high risk aggressive T-cell non-Hodgkin lymphoma

a SWOG 9704 intergroup trial subgroup analysis

Zeina Al-Mansour*, Hongli Li, James R. Cook, Louis S. Constine, Stephen Couban, Douglas A. Stewart, Thomas C. Shea, Pierluigi Porcu, Jane Norma Winter, Brad S. Kahl, Sonali M. Smith, Deborah C. Marcellus, Kevin P. Barton, Glenn M. Mills, Michael LeBlanc, Lisa M. Rimsza, Stephen J. Forman, John P. Leonard, Richard I. Fisher, Jonathan W. Friedberg & 1 others Patrick J. Stiff

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Phase II data suggest a benefit to autotransplantation for aggressive T-cell non-Hodgkin lymphoma (T-NHL) in first remission; randomized trials have yet to validate this. We performed a retrospective analysis of aggressive T-NHL patients in the intergroup randomized consolidative autotransplant trial (SWOG 9704). Of the 370 enrolled, 40 had T-NHL: 12 were not randomized due to ineligibility (n = 1), choice (n = 2), or progression (n = 9), leaving 13 randomized to control and 15 to autologous stem cell transplantation (ASCT). Two ASCT patients refused transplant and one failed mobilization. The 5-year landmark PFS/OS estimates for ASCT vs. control groups were 40% vs. 38% (p =.56), and 40% vs. 45% (p =.98), respectively. No difference was seen based on IPI, or histologic subtype. Only 1/7 receiving BCNU-based therapy survived vs. 4/5 receiving TBI. Aggressive T-NHL autotransplanted in first remission did not appear to benefit from consolidative ASCT. This and the 30% who dropped out pre-randomization mostly to progression, suggests that improved induction regimens be developed.

Original languageEnglish (US)
Pages (from-to)1934-1941
Number of pages8
JournalLeukemia and Lymphoma
Volume60
Issue number8
DOIs
StatePublished - Jul 3 2019

Fingerprint

T-Cell Lymphoma
Autologous Transplantation
Stem Cell Transplantation
Non-Hodgkin's Lymphoma
Carmustine
Autografts
Random Allocation
Transplants
Control Groups
Therapeutics

Keywords

  • T-NHL treatment
  • consolidative autotransplant
  • high-risk T-NHL

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Al-Mansour, Zeina ; Li, Hongli ; Cook, James R. ; Constine, Louis S. ; Couban, Stephen ; Stewart, Douglas A. ; Shea, Thomas C. ; Porcu, Pierluigi ; Winter, Jane Norma ; Kahl, Brad S. ; Smith, Sonali M. ; Marcellus, Deborah C. ; Barton, Kevin P. ; Mills, Glenn M. ; LeBlanc, Michael ; Rimsza, Lisa M. ; Forman, Stephen J. ; Leonard, John P. ; Fisher, Richard I. ; Friedberg, Jonathan W. ; Stiff, Patrick J. / Autologous transplantation as consolidation for high risk aggressive T-cell non-Hodgkin lymphoma : a SWOG 9704 intergroup trial subgroup analysis. In: Leukemia and Lymphoma. 2019 ; Vol. 60, No. 8. pp. 1934-1941.
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abstract = "Phase II data suggest a benefit to autotransplantation for aggressive T-cell non-Hodgkin lymphoma (T-NHL) in first remission; randomized trials have yet to validate this. We performed a retrospective analysis of aggressive T-NHL patients in the intergroup randomized consolidative autotransplant trial (SWOG 9704). Of the 370 enrolled, 40 had T-NHL: 12 were not randomized due to ineligibility (n = 1), choice (n = 2), or progression (n = 9), leaving 13 randomized to control and 15 to autologous stem cell transplantation (ASCT). Two ASCT patients refused transplant and one failed mobilization. The 5-year landmark PFS/OS estimates for ASCT vs. control groups were 40{\%} vs. 38{\%} (p =.56), and 40{\%} vs. 45{\%} (p =.98), respectively. No difference was seen based on IPI, or histologic subtype. Only 1/7 receiving BCNU-based therapy survived vs. 4/5 receiving TBI. Aggressive T-NHL autotransplanted in first remission did not appear to benefit from consolidative ASCT. This and the 30{\%} who dropped out pre-randomization mostly to progression, suggests that improved induction regimens be developed.",
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author = "Zeina Al-Mansour and Hongli Li and Cook, {James R.} and Constine, {Louis S.} and Stephen Couban and Stewart, {Douglas A.} and Shea, {Thomas C.} and Pierluigi Porcu and Winter, {Jane Norma} and Kahl, {Brad S.} and Smith, {Sonali M.} and Marcellus, {Deborah C.} and Barton, {Kevin P.} and Mills, {Glenn M.} and Michael LeBlanc and Rimsza, {Lisa M.} and Forman, {Stephen J.} and Leonard, {John P.} and Fisher, {Richard I.} and Friedberg, {Jonathan W.} and Stiff, {Patrick J.}",
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Al-Mansour, Z, Li, H, Cook, JR, Constine, LS, Couban, S, Stewart, DA, Shea, TC, Porcu, P, Winter, JN, Kahl, BS, Smith, SM, Marcellus, DC, Barton, KP, Mills, GM, LeBlanc, M, Rimsza, LM, Forman, SJ, Leonard, JP, Fisher, RI, Friedberg, JW & Stiff, PJ 2019, 'Autologous transplantation as consolidation for high risk aggressive T-cell non-Hodgkin lymphoma: a SWOG 9704 intergroup trial subgroup analysis', Leukemia and Lymphoma, vol. 60, no. 8, pp. 1934-1941. https://doi.org/10.1080/10428194.2018.1563691

Autologous transplantation as consolidation for high risk aggressive T-cell non-Hodgkin lymphoma : a SWOG 9704 intergroup trial subgroup analysis. / Al-Mansour, Zeina; Li, Hongli; Cook, James R.; Constine, Louis S.; Couban, Stephen; Stewart, Douglas A.; Shea, Thomas C.; Porcu, Pierluigi; Winter, Jane Norma; Kahl, Brad S.; Smith, Sonali M.; Marcellus, Deborah C.; Barton, Kevin P.; Mills, Glenn M.; LeBlanc, Michael; Rimsza, Lisa M.; Forman, Stephen J.; Leonard, John P.; Fisher, Richard I.; Friedberg, Jonathan W.; Stiff, Patrick J.

In: Leukemia and Lymphoma, Vol. 60, No. 8, 03.07.2019, p. 1934-1941.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Autologous transplantation as consolidation for high risk aggressive T-cell non-Hodgkin lymphoma

T2 - a SWOG 9704 intergroup trial subgroup analysis

AU - Al-Mansour, Zeina

AU - Li, Hongli

AU - Cook, James R.

AU - Constine, Louis S.

AU - Couban, Stephen

AU - Stewart, Douglas A.

AU - Shea, Thomas C.

AU - Porcu, Pierluigi

AU - Winter, Jane Norma

AU - Kahl, Brad S.

AU - Smith, Sonali M.

AU - Marcellus, Deborah C.

AU - Barton, Kevin P.

AU - Mills, Glenn M.

AU - LeBlanc, Michael

AU - Rimsza, Lisa M.

AU - Forman, Stephen J.

AU - Leonard, John P.

AU - Fisher, Richard I.

AU - Friedberg, Jonathan W.

AU - Stiff, Patrick J.

PY - 2019/7/3

Y1 - 2019/7/3

N2 - Phase II data suggest a benefit to autotransplantation for aggressive T-cell non-Hodgkin lymphoma (T-NHL) in first remission; randomized trials have yet to validate this. We performed a retrospective analysis of aggressive T-NHL patients in the intergroup randomized consolidative autotransplant trial (SWOG 9704). Of the 370 enrolled, 40 had T-NHL: 12 were not randomized due to ineligibility (n = 1), choice (n = 2), or progression (n = 9), leaving 13 randomized to control and 15 to autologous stem cell transplantation (ASCT). Two ASCT patients refused transplant and one failed mobilization. The 5-year landmark PFS/OS estimates for ASCT vs. control groups were 40% vs. 38% (p =.56), and 40% vs. 45% (p =.98), respectively. No difference was seen based on IPI, or histologic subtype. Only 1/7 receiving BCNU-based therapy survived vs. 4/5 receiving TBI. Aggressive T-NHL autotransplanted in first remission did not appear to benefit from consolidative ASCT. This and the 30% who dropped out pre-randomization mostly to progression, suggests that improved induction regimens be developed.

AB - Phase II data suggest a benefit to autotransplantation for aggressive T-cell non-Hodgkin lymphoma (T-NHL) in first remission; randomized trials have yet to validate this. We performed a retrospective analysis of aggressive T-NHL patients in the intergroup randomized consolidative autotransplant trial (SWOG 9704). Of the 370 enrolled, 40 had T-NHL: 12 were not randomized due to ineligibility (n = 1), choice (n = 2), or progression (n = 9), leaving 13 randomized to control and 15 to autologous stem cell transplantation (ASCT). Two ASCT patients refused transplant and one failed mobilization. The 5-year landmark PFS/OS estimates for ASCT vs. control groups were 40% vs. 38% (p =.56), and 40% vs. 45% (p =.98), respectively. No difference was seen based on IPI, or histologic subtype. Only 1/7 receiving BCNU-based therapy survived vs. 4/5 receiving TBI. Aggressive T-NHL autotransplanted in first remission did not appear to benefit from consolidative ASCT. This and the 30% who dropped out pre-randomization mostly to progression, suggests that improved induction regimens be developed.

KW - T-NHL treatment

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