A randomized phase 3 trial of auto vs. allo transplantation as part of first-line therapy in poor-risk peripheral T-NHL - Université de Montpellier Accéder directement au contenu
Article Dans Une Revue Blood Année : 2021

A randomized phase 3 trial of auto vs. allo transplantation as part of first-line therapy in poor-risk peripheral T-NHL

1 UKM - University Hospital Münster - Universitaetsklinikum Muenster [Germany]
2 Georg-August-University = Georg-August-Universität Göttingen
3 Hôpital Haut-Lévêque [CHU Bordeaux]
4 Leipzig University / Universität Leipzig
5 Hôpital Henri Mondor
6 IGMM - Institut de Génétique Moléculaire de Montpellier
7 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
8 CHU Limoges
9 Kliniken Essen-Mitte
10 University Medical Center [Mainz]
11 PMU - Paracelsus Medizinische Privatuniversität = Paracelsus Medical University
12 Centre Hospitalier Saint Jean de Perpignan
13 MICMAC - Microenvironment, Cell Differentiation, Immunology and Cancer
14 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
15 CHUV - Centre Hospitalier Universitaire Vaudois = Lausanne University Hospital [Lausanne]
16 JMU - Julius-Maximilians-Universität Würzburg
17 IUCT Oncopole - UMR 1037 - Institut Universitaire du Cancer de Toulouse - Oncopole
18 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
19 University Hospital Carl Gustav Carus [Dresden, Germany]
20 Catholic Hospital = Katholisches Krankenhaus [Hagen]
21 Universität Heidelberg [Heidelberg] = Heidelberg University
22 Universitätsklinikum Ulm - University Hospital of Ulm
23 AP-HP - Hopital Saint-Louis [AP-HP]
24 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
25 CHU Clermont-Ferrand
26 Helios-Klinikum Berlin-Buch
27 University Hospital Homburg
28 IHBN - Institut d'Hématologie de Basse-Normandie
29 Hôpital Necker - Enfants Malades [AP-HP]
30 Hôpital Robert Debré
31 ICANS - Institut de Cancérologie de Strasbourg Europe
32 CHCB - Centre Hospitalier de la Côte Basque
33 Hospital of Chemnitz
34 Klinikum der Universität [München]
35 Klinikum Oldenburg
36 Charité - UniversitätsMedizin = Charité - University Hospital [Berlin]
37 Onkologie Lerchenfeld [Hamburg]
38 CHU Estaing [Clermont-Ferrand]
39 CHELTER - Role of intra-Clonal Heterogeneity and Leukemic environment in ThErapy Resistance of chronic leukemias
40 CIC Clermont Ferrand
Arnaud Jaccard
  • Fonction : Auteur
Bernd Metzner
  • Fonction : Auteur

Résumé

First-line therapy for younger patients with peripheral T-cell non-Hodgkin lymphoma (T-NHL) consists of 6 courses of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) with or without etoposide (CHOEP), consolidated by high-dose therapy and autologous stem cell transplantation (auto-SCT). We hypothesized that allogeneic stem cell transplantation (allo-SCT) could improve outcomes. 104 patients with peripheral T-cell non-Hodgkin lymphoma, except ALK+ anaplastic large cell lymphoma, 18 to 60 years, all stages, and all age adjusted International Prognostic Index scores, except 0 and stage I, were randomized to 4 cycles of CHOEP and 1 cycle of dexamethasone, cytosine-arabinoside, and platinum (DHAP) followed by high-dose therapy and auto-SCT or myeloablative conditioning and allo-SCT. The primary end point was event-free survival (EFS) at 3 years. After a median follow-up of 42 months, the 3-year EFS after allo-SCT was 43%, as compared with 38% after auto-SCT. Overall survival at 3 years was 57% vs 70% after allo- or auto-SCT, without significant differences between treatment arms. None of the 21 responding patients proceeding to allo-SCT relapsed, as opposed to 13 of 36 patients (36%) proceeding to auto-SCT. Eight of 26 patients (31%) and none of 41 patients died of transplant-related toxicity after allo- and auto-SCT, respectively. The strong graft-versus-lymphoma effect after allo-SCT was counterbalanced by transplant-related mortality. This trial is registered at www.clinicaltrials.gov as #NCT00984412.

Domaines

Hématologie
Fichier principal
Vignette du fichier
Schmitz et al-2021-A randomized phase 3 trial of auto vs.pdf (1.75 Mo) Télécharger le fichier
Origine : Fichiers produits par l'(les) auteur(s)

Dates et versions

hal-03163608 , version 1 (31-03-2021)

Identifiants

Citer

Norbert Schmitz, Lorenz Truemper, Krimo Bouabdallah, Marita Ziepert, Mathieu Leclerc, et al.. A randomized phase 3 trial of auto vs. allo transplantation as part of first-line therapy in poor-risk peripheral T-NHL. Blood, 2021, 2020008825, ⟨10.1182/blood.2020008825⟩. ⟨hal-03163608⟩
530 Consultations
431 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More