1. ¹BMTU, St James's University Hospital, Leeds, UK
2. ²Department of Haematology, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Australia
3. ³BSBMT, University College Hospital, London, UK
4. ⁴ABMTRR, St Vincent's Hospital, Sydney, Australia
5. ⁵Department of Haematology, King's College Hospital, London, UK
6. ⁶Department of Haematology, Royal Prince Alfred Hospital, Sydney, Australia
7. ⁷Canterbury Health Laboratories, Christchurch, New Zealand
8. ⁸Department of Haematology, Westmead Hospital, Sydney, Australia
9. ⁹Department of Haematology, United Bristol Healthcare Trust, Bristol, UK

Correspondence: Dr G Cook, Blood and Marrow Transplantation, Leeds Teaching Hospitals Trust, St James' University Hospital, Beckett Street, Leeds, West Yorks LS9 7TF, UK. E-mail: Gordon.Cook@leedsth.nhs.uk

Received 3 January 2007; Revised 28 April 2007; Accepted 3 May 2007; Published online 25 June 2007.

Abstract

Peripheral T-cell lymphomas (PTCL) are a rare and heterogeneous subset of lymphomas with a poorer prognosis compared with B-cell lymphomas. We conducted a retrospective study of 82 patients who received high-dose therapy for PTCL (autologous SCT (ASCT) N=64; allogeneic SCT (Allo-SCT) N=18). With a median follow-up from ASCT of 37 months from transplant, 33 patients were alive; 20 died of progressive disease, 10 died from non-relapse mortality (NRM) with 1 unknown cause. Three-year overall survival (OS) and progression-free survival (PFS) were 53% (95% confidence interval (CI) 42, 67) and 50% (95% CI 39, 64), respectively. Factors significantly affecting OS and PFS on univariate analysis were histological subtype and chemotherapy sensitivity. In a multivariate analysis, the only factor with significant impact was chemotherapy sensitivity. After a median follow-up from Allo-SCT of 57 months, five patients were alive; five died of progressive disease and eight died from NRM. The 3-year OS and PFS were 39% (95% CI 22, 69) and 33% (95% CI 17, 64), respectively, and the 3-year relapse rate was 28% (95% CI 6, 50). These results demonstrate that high-dose chemotherapy with autologous stem cell rescue has a substantial role in the management of T-cell lymphoma. The use of full-intensity allogeneic transplantation is limited by high transplant-related mortality, and exploration of reduced intensity regimens is warranted.