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 N. Winter, Brad S. Kahl, Sonali M. Smith, Deborah C. Marcellus, Kevin P. Barton, Glenn M. Mills, Michael LeBlanc, Lisa Rimsza, Stephen J. Forman, John P. Leonard, Richard I. Fisher, Jonathan W. FriedbergPatrick J. Stiff

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)
JournalLeukemia and Lymphoma
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

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

Keywords

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

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

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 N.; Kahl, Brad S.; Smith, Sonali M.; Marcellus, Deborah C.; Barton, Kevin P.; Mills, Glenn M.; LeBlanc, Michael; Rimsza, Lisa; Forman, Stephen J.; Leonard, John P.; Fisher, Richard I.; Friedberg, Jonathan W.; Stiff, Patrick J.

In: Leukemia and Lymphoma, 01.01.2019.

Research output: Contribution to journalArticle

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, L, 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. https://doi.org/10.1080/10428194.2018.1563691
Al-Mansour, Zeina ; Li, Hongli ; Cook, James R. ; Constine, Louis S. ; Couban, Stephen ; Stewart, Douglas A. ; Shea, Thomas C. ; Porcu, Pierluigi ; Winter, Jane N. ; Kahl, Brad S. ; Smith, Sonali M. ; Marcellus, Deborah C. ; Barton, Kevin P. ; Mills, Glenn M. ; LeBlanc, Michael ; Rimsza, Lisa ; 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.
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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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