Autologous transplantation as consolidation for high risk aggressive T-cell non-Hodgkin lymphoma: a SWOG 9704 intergroup trial subgroup analysis

Abstract

Phase II data suggest a benefit to autotransplantation for aggressive T-cell non-Hodgkin lymphoma (T-NHL) in first remission; randomized trials have yet to validate this. We performed a retrospective analysis of aggressive T-NHL patients in the intergroup randomized consolidative autotransplant trial (SWOG 9704). Of the 370 enrolled, 40 had T-NHL: 12 were not randomized due to ineligibility (n = 1), choice (n = 2), or progression (n = 9), leaving 13 randomized to control and 15 to autologous stem cell transplantation (ASCT). Two ASCT patients refused transplant and one failed mobilization. The 5-year landmark PFS/OS estimates for ASCT vs. control groups were 40% vs. 38% (p = .56), and 40% vs. 45% (p = .98), respectively. No difference was seen based on IPI, or histologic subtype. Only 1/7 receiving BCNU-based therapy survived vs. 4/5 receiving TBI. Aggressive T-NHL autotransplanted in first remission did not appear to benefit from consolidative ASCT. This and the 30% who dropped out pre-randomization mostly to progression, suggests that improved induction regimens be developed.

Keywords:

• T-NHL treatment
• consolidative autotransplant
• high-risk T-NHL

Acknowledgments

The contributions of Dr. Raymond R Tubbs to this work are recognized posthumously and gratefully acknowledged by his coauthors.

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article online at https://doi.org/10.1080/10428194.2018.1563691.

Additional information

Funding

Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under the following award numbers: CA180888, CA180819, CA180820, CA180821, CA180863, CCSRI #021039; legacy grants CA46282, CA04919, CA11083, CA58658, CA46368, CA13612; and in part by Bristol-Myers Squibb. The content is solely the responsibility of the authors and does not necessarily represent the official views of either the National Institutes of Health or Bristol-Myers Squibb.