Comparison Of Allogeneic Hematopoietic Cell Transplantation Versus Chemotherapy In Patients With T Cell Lymphoma

Objective:To compare the efficiency and safety of allogeneic hematopoietic stem cell transplantation versus chemotherapy in patients with T cell lymphoma. To analyze the clinical features and prognostic factors of these patients.Methods:59patients who were diagnosed as T cell lymphoma by pathology between Jan1st2007to Dec312012in the First Affiliated Hospital of Zhejiang University School of Medicine were enrolled and analyzed retrospectively. All of the cases were determined according to WHO2008classification and classified by Ann Arbor staging system. These patients were all younger than60years old at clinical stage Ⅲ/Ⅳ period and have completed two or more courses chemotherapy.19patients finally received allogeneic stem cell transplantation and40patients still received chemotherapy, followed up by telephone to Dec312013. We evaluate the PFS and OS between two groups. At the same time, some clinical factors such as the level of serum lactate dehydrogenase (LDH), B symptoms, and international prognostic index (IPI) were collected to analyze the relation between these parameters and survival.Results:After a median follow-up of21months, one-year overall survival(OS) of SCT and CTx were94.4%and65.0%(p<0.05). Three-year OS of SCT and CTx were57.2%and39.1%(p<0.05). Five-year OS of SCT and CTx were45.8%and23.1%(p <0.05). One-year progression-free survival(PFS) of SCT and CTx were88.5%and47.5%(p<0.001). Three-year PFS of SCT and CTx were51.5%and22.5%(p<0.001). Five-year PFS of SCT and CTx were41.2%and7.5%(p<0.001). The treatment related mortality (TRM) rate has no statistical significance between the two groups.100-day TRM of SCT and CTx were2.5%and10.5%(P=0.190). One-year TRM of SCT and CTx were17.5%and15.8%(P=0.870). Three-year TRM of SCT and CTx were27.5%and21.1%(P=0.595). Five-year TRM of SCT and CTx were30.0%and26.3%(P=0.770).The level of serum LDH, extranodal violations, Ann Arbor stage and international prognostic index (IPI) were statistically relevant in predicting the prognosis of the overall survival (OS). Multivariate analysis showed that only treatment is an independent prognostic factor.Conclusions:Allogeneic hematopoietic stem cell transplantation is safe and effective for T cell lymphoma patients and can result in long-term disease control.