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The adjusted International Prognostic Index and ß-2-microglobulin predict the outcome after autologous stem cell transplantation in relapsing/refractory peripheral T-cell lymphoma

From the University Hospital Son Dureta, Palma de Mallorca (JR, AG); Hospital Valdecilla, Santander (EC); Hospital 12 de Octubre, Madrid (JJL); Hospital La Princesa, Madrid (RA); Hospital Sant Pau, Barcelona (AS); Hospital Vall d’Hebron, Barcelona (JZ); Instituto Catalán de Oncología, Barcelona (AFdS); Clínica Universitaria de Navarra, Pamplona (MB); Hospital Clínico Universitario, Valencia (CS); Hospital de Jerez de La Frontera, Cádiz (AL); Hospital Juan Canalejo, La Coruña (MRV); Hospital Clínico, Salamanca (MDC)

Correspondence: José Rodríguez, MD, PhD, Oncology Department, University Hospital Son Dureta. Av. Andrea Doria, 55, Palma de Mallorca, Balearic Islands, 07014 Spain. E-mail: jrodriguez{at}hsd.es

Background and Objectives: Preliminary data on the use of autologous stem cell transplantation (ASCT) as a salvage therapy for peripheral T-cell lymphoma (PTCL) indicate that the results are similar to those obtained in aggressive B-cell lymphomas. The aim of our study was to analyze outcomes of a large series of patients with PTCL with a prolonged follow-up who received ASCT as salvage therapy.

Design and Methods: Between 1990 and 2004, 123 patients in this situation were registered in the GELTAMO database. The median age at transplantation was 43.5 years; in 91% of patients the disease was chemosensitive.

Results: Seventy-three percent of the patients achieved complete remission, 11% partial remission and the procedure failed in 16%. At a median follow-up of 61 months, the 5-year overall and progression-free survival rates were 45% and 34%, respectively. The presence of more than one factor of the adjusted International Prognostic Index (a-IPI) and a high ß2-microglobulin at transplantation were identified as adverse prognostic factors for both overall and progression-free survival and allowed the population to be stratified into three distinct risk groups.

Interpretation and Conclusions: Our data show that approximately one third of patients with PTCL in the salvage setting may enjoy prolonged survival following ASCT, provided they are transplanted in a chemosensitive disease state. The a-IPI and ß2-microglobulin level predict the outcome after ASCT in relapsing/refractory PTCL.

Key words: peripheral T-cell lymphoma, international prognostic index, ß-2-microglobulin, autologous stem cell transplantation.

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