We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Intensive Induction Therapy Compared With CHOP for Hepatosplenic T-cell Lymphoma.
- Authors
Klebaner, Daniella; Koura, Divya; Tzachanis, Dimitrios; Ball, Edward D.; Horwitz, Steven; Goodman, Aaron M.
- Abstract
<bold>Introduction: </bold>Hepatosplenic T-cell lymphoma (HSTCL) is a rare peripheral T-cell lymphoma that disproportionately affects individuals with a clinical history of immunosuppression. It carries a poor prognosis, and, owing to its rarity, there is no single or well-established treatment.<bold>Patients and Methods: </bold>We conducted the largest-to-date individual-level meta-analysis based on literature searches to determine the best induction therapy for HSTCL. We compared response rates and survival among patients who received "non-CHOP-based" induction with regimens containing cytarabine, etoposide, and/or platinum-based treatment to those receiving treatment with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) or CHOP-like therapy. We also review additional regimens including alemtuzumab and pentostatin, and assessed the role of consolidation with hematopoietic stem-cell transplantation (HSCT).<bold>Results: </bold>We identified 166 patients with HSTCL, 118 of whom had sufficient information on induction treatment and survival. Eighty-four patients received non-CHOP-based (N = 34) or CHOP/CHOP-like (N = 50) induction treatment. Non-CHOP-based induction was associated with a complete/partial response rate of 82% compared with 52% (P = .006) with CHOP/CHOP-like and increased median overall survival (P = .00014). Our data showed that maximum survival among patients with HSTCL was achieved with non-CHOP-based induction followed by consolidation with HSCT.<bold>Conclusions: </bold>Non-CHOP-based induction appears superior to CHOP/CHOP-like induction in both achieving complete/partial response and durable survival. Induction therapy of HSTCL should be intensified with non-CHOP-based regimens and followed by consolidation with HSCT in eligible patients.
- Subjects
THERAPEUTIC use of antineoplastic agents; PREDNISOLONE; DOXORUBICIN; ANTINEOPLASTIC agents; CYCLOPHOSPHAMIDE; T-cell lymphoma; VINCRISTINE; PHARMACODYNAMICS
- Publication
Clinical Lymphoma, Myeloma & Leukemia, 2020, Vol 20, Issue 7, p431
- ISSN
2152-2650
- Publication type
journal article
- DOI
10.1016/j.clml.2019.10.007