In an analysis reported in the Journal of Clinical Oncology, Tournilhac et al identified 7-year outcomes of the phase III AATT trial evaluating autologous vs allogeneic transplantation in younger patients with peripheral T-cell lymphoma.
Study Details
In the trial, 103 patients (aged 18–60) from sites in France and Germany were randomly assigned to receive consolidation with autologous hematopoietic stem cell transplantation (autoSCT, n = 54) or allogeneic hematopoietic SCT (alloSCT, n = 49). Primary analysis of the trial showed that autoSCT and alloSCT were associated with similar event-free and overall survival outcomes. The current report presents 7-year outcomes.
Key Findings
At 7 years in the intention-to-treat population, the event-free survival rate was 38% (95% confidence interval [CI] = 25%–52%) in the alloSCT group vs 34% (95% CI = 22%–47%) in the autoSCT group; the progression-free survival rate was 38% (95% CI = 25%–52%) vs 35% (95% CI = 22%–48%); and the overall survival rate was 55% (95% CI = 41%–69%) vs 61% (95% CI = 47%–74%). No statistically significant differences in outcomes between the two groups were observed.
A total of 26 patients in the alloSCT group vs 41 in the autoSCT group actually underwent transplantation on study. Among these patients, at 7 years, the event-free survival rate was 61% vs 50%, the progression-free survival rate was 61% vs 50%, and the overall survival rate was 61% vs 72%; none of the differences was found to be statistically significant. The cumulative rate of relapse or disease progression was 8% vs 55%. Nonrelapse mortality rate was 31% vs 3%.
Overall, 15 patients with early disease progression and 11 with disease progression or relapse after autoSCT received salvage alloSCT. Overall survival rate at 7 years after salvage alloSCT was 61%. Nonrelapse mortality rate rwas 23%.
The investigators concluded: “Long-term follow-up documents the strong graft vs lymphoma effect of alloSCT independent of the timing of transplantation. Survival of patients unable to undergo transplantation was dismal. AlloSCT is the treatment of choice for younger, transplant-eligible patients with relapsed/refractory [peripheral T-cell lymphoma]. AlloSCT is currently not recommended as part of first-line consolidation.”
Norbert Schmitz, MD, of University Hospital Muenster, Germany, is the corresponding author of the Journal of Clinical Oncology article.
Disclosure: The study was supported by a grant from the Bundesministerium für Bildung und Forschung, a grant from the Ministère de la Santè et des Solidaritè, and others. For full disclosures of the study authors, visit ascopubs.org.
