High-dose therapy with autologous stem cell transplantation in patients with peripheral T cell lymphomas

Peripheral T cell lymphomas (PTCL) have a poorer prognosis after convention al treatment than do high-grade B cell lymphomas, The place for high-dose t herapy (HDT) with autologous stem cell support in these patients is still n ot clear. Forty patients, 10 women and 30 men, median age 41.5 years (range 16-61) with PTCL were treated with HDT and autologous stem cell support at The Norwegian Radium Hospital, Oslo, Norway and The University Hospital, U ppsala, Sweden, between February 1990 and September 1999, The histologic su btypes were: PTCL unspecified, 20 patients; intestinal, two patients; angio immunoblastic (AILD), two patients; angiocentric, two patients and anaplast ic large cell lymphoma (ALCL), 14 patients. All patients had chemosensitive disease and had received anthracycline-containing regimens prior to transp lantation. At the time of HDT, 17 patients were in first PR or CR and 23 we re in second or third PR or CR, Conditioning regimens were BEAM in 15 patie nts, BEAC in 14 patients, cyclophosphamide and total body irradiation (TBI) in eight patients, BEAC, without etoposide and TBI in one patient and mito xantrone and melphalan in two patients. There were three (7.5%) treatment-r elated deaths. The estimated overall survival (OS) at 3 years was 58%, the event-free survival (EFS) 48% and the relapse-free survival (RFS) 56%, with a median followup of 36 months (range 7-100) for surviving patients. The p atients with ALCL tended to have a better prognosis compared to those with other PTCL subtypes, OS 79% vs 44%, respectively. In conclusion, patients w ith chemosensitive PTCL who are failing to achieve CR with first-line chemo therapy or are in relapse can successfully be treated with HDT and autologo us stem cell support.