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Impact of etoposide and ASCT on survival among patients aged <65 years with stage II to IV PTCL: a population-based cohort study
Patients aged <65 years with peripheral T-cell lymphoma (PTCL) are treated with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP). Although the addition of etoposide (CHOEP) and consolidation with autologous stem cell transplantation (ASCT) are preferred in some countries, randomi...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Society of Hematology
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9437712/ https://www.ncbi.nlm.nih.gov/pubmed/35544601 http://dx.doi.org/10.1182/blood.2021015114 |
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author | Brink, Mirian Meeuwes, Frederik O. van der Poel, Marjolein W. M. Kersten, Marie José Wondergem, Mariëlle Mutsaers, Pim G. N. J. Böhmer, Lara H. Woei-A-Jin, F. J. Sherida H. Visser, Otto Oostvogels, Rimke Jansen, Patty M. Plattel, Wouter Huls, Gerwin A. Vermaat, Joost S. P. Nijland, Marcel |
author_facet | Brink, Mirian Meeuwes, Frederik O. van der Poel, Marjolein W. M. Kersten, Marie José Wondergem, Mariëlle Mutsaers, Pim G. N. J. Böhmer, Lara H. Woei-A-Jin, F. J. Sherida H. Visser, Otto Oostvogels, Rimke Jansen, Patty M. Plattel, Wouter Huls, Gerwin A. Vermaat, Joost S. P. Nijland, Marcel |
author_sort | Brink, Mirian |
collection | PubMed |
description | Patients aged <65 years with peripheral T-cell lymphoma (PTCL) are treated with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP). Although the addition of etoposide (CHOEP) and consolidation with autologous stem cell transplantation (ASCT) are preferred in some countries, randomized trials are lacking. This nationwide population-based study assessed the impact of etoposide and ASCT on overall survival (OS) among patients aged 18 to 64 years with stage II to IV anaplastic large-cell lymphoma (ALCL), angioimmunoblastic T-cell lymphoma (AITL), or PTCL not otherwise specified (NOS) diagnosed between 1989 and 2018 using the Netherlands Cancer Registry. Patients were categorized into 2 calendar periods, representing pre- and post-eras of etoposide and ASCT, respectively. A total of 1427 patients were identified (ALCL, 35%; AITL, 21%; and PTCL NOS, 44%). OS increased from 39% in the period from 1989 to 2009 to 49% in the period of 2009 to 2018 (P < .01). Five-year OS was superior for patients treated with CHOEP vs CHOP (64% and 44%, respectively; P < .01). When adjusted for subtype, International Prognostic Index score, and ASCT, the risk of mortality was similar between the 2 groups, except for patients with ALK(+) ALCL, for whom the risk of mortality was 6.3 times higher when treated with CHOP vs CHOEP. Patients undergoing consolidation with ASCT had superior 5-year OS of 81% compared with 39% for patients not undergoing ASCT (P < .01), regardless of whether complete remission was achieved. In patients aged <65 years with advanced-stage ALK(−) ALCL, AITL, or PTCL, the use of ASCT consolidation, but not the addition of etoposide, was associated with improved OS. |
format | Online Article Text |
id | pubmed-9437712 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | American Society of Hematology |
record_format | MEDLINE/PubMed |
spelling | pubmed-94377122022-11-16 Impact of etoposide and ASCT on survival among patients aged <65 years with stage II to IV PTCL: a population-based cohort study Brink, Mirian Meeuwes, Frederik O. van der Poel, Marjolein W. M. Kersten, Marie José Wondergem, Mariëlle Mutsaers, Pim G. N. J. Böhmer, Lara H. Woei-A-Jin, F. J. Sherida H. Visser, Otto Oostvogels, Rimke Jansen, Patty M. Plattel, Wouter Huls, Gerwin A. Vermaat, Joost S. P. Nijland, Marcel Blood Lymphoid Neoplasia Patients aged <65 years with peripheral T-cell lymphoma (PTCL) are treated with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP). Although the addition of etoposide (CHOEP) and consolidation with autologous stem cell transplantation (ASCT) are preferred in some countries, randomized trials are lacking. This nationwide population-based study assessed the impact of etoposide and ASCT on overall survival (OS) among patients aged 18 to 64 years with stage II to IV anaplastic large-cell lymphoma (ALCL), angioimmunoblastic T-cell lymphoma (AITL), or PTCL not otherwise specified (NOS) diagnosed between 1989 and 2018 using the Netherlands Cancer Registry. Patients were categorized into 2 calendar periods, representing pre- and post-eras of etoposide and ASCT, respectively. A total of 1427 patients were identified (ALCL, 35%; AITL, 21%; and PTCL NOS, 44%). OS increased from 39% in the period from 1989 to 2009 to 49% in the period of 2009 to 2018 (P < .01). Five-year OS was superior for patients treated with CHOEP vs CHOP (64% and 44%, respectively; P < .01). When adjusted for subtype, International Prognostic Index score, and ASCT, the risk of mortality was similar between the 2 groups, except for patients with ALK(+) ALCL, for whom the risk of mortality was 6.3 times higher when treated with CHOP vs CHOEP. Patients undergoing consolidation with ASCT had superior 5-year OS of 81% compared with 39% for patients not undergoing ASCT (P < .01), regardless of whether complete remission was achieved. In patients aged <65 years with advanced-stage ALK(−) ALCL, AITL, or PTCL, the use of ASCT consolidation, but not the addition of etoposide, was associated with improved OS. American Society of Hematology 2022-09-01 /pmc/articles/PMC9437712/ /pubmed/35544601 http://dx.doi.org/10.1182/blood.2021015114 Text en © 2022 by The American Society of Hematology. https://creativecommons.org/licenses/by-nc-nd/4.0/Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved. |
spellingShingle | Lymphoid Neoplasia Brink, Mirian Meeuwes, Frederik O. van der Poel, Marjolein W. M. Kersten, Marie José Wondergem, Mariëlle Mutsaers, Pim G. N. J. Böhmer, Lara H. Woei-A-Jin, F. J. Sherida H. Visser, Otto Oostvogels, Rimke Jansen, Patty M. Plattel, Wouter Huls, Gerwin A. Vermaat, Joost S. P. Nijland, Marcel Impact of etoposide and ASCT on survival among patients aged <65 years with stage II to IV PTCL: a population-based cohort study |
title | Impact of etoposide and ASCT on survival among patients aged <65 years with stage II to IV PTCL: a population-based cohort study |
title_full | Impact of etoposide and ASCT on survival among patients aged <65 years with stage II to IV PTCL: a population-based cohort study |
title_fullStr | Impact of etoposide and ASCT on survival among patients aged <65 years with stage II to IV PTCL: a population-based cohort study |
title_full_unstemmed | Impact of etoposide and ASCT on survival among patients aged <65 years with stage II to IV PTCL: a population-based cohort study |
title_short | Impact of etoposide and ASCT on survival among patients aged <65 years with stage II to IV PTCL: a population-based cohort study |
title_sort | impact of etoposide and asct on survival among patients aged <65 years with stage ii to iv ptcl: a population-based cohort study |
topic | Lymphoid Neoplasia |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9437712/ https://www.ncbi.nlm.nih.gov/pubmed/35544601 http://dx.doi.org/10.1182/blood.2021015114 |
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