Background Peripheral T-cell lymphoma (PTCL) remains a therapeutic challenge. Due to the rarity and the heterogeneity of PTCL, no consensus has been achieved regarding even the type of first-line treatment. The benefit of autologous stem-cell transplantation (ASCT) is, therefore, still intensely debated. Patients and methods In the absence of randomized trials addressing the role of ASCT, we performed a large multicentric retrospective study and used both a multivariate proportional hazard model and a propensity score matching approach to correct for sample selection bias between patients allocated or not to ASCT in intention-to-treat (ITT). Results Among 527 patients screened from 14 centers in France, Belgium and Portugal, a final cohort of 269 patients ≤65 years old with PTCL-not otherwise specified (NOS) (N = 78, 29%), angioimmunoblastic T-cell lymphoma (AITL) (N = 123, 46%) and anaplastic lymphoma kinase-positive anaplastic large cell lymphoma (ALK-ALCL) (N = 68, 25%) with partial (N = 52, 19%) or complete responses (N = 217, 81%) after induction was identified and information about treatment allocation was carefully collected before therapy initiation from medical records. One hundred and thirty-four patients were allocated to ASCT in ITT and 135 were not. Neither the Cox multivariate model (HR = 1.02; 95% CI: 0.69-1.50 for PFS and HR = 1.08; 95% CI: 0.68-1.69 for OS) nor the propensity score analysis after stringent matching for potential confounding factors (logrank P = 0.90 and 0.66 for PFS and OS, respectively) found a survival advantage in favor of ASCT as a consolidation procedure for patients in response after induction. Subgroup analyses did not reveal any further difference for patients according to response status, stage disease or risk category. Conclusions The present data do not support the use of ASCT for up-front consolidation for all patients with PTCL-NOS, AITL, or ALK-ALCL with partial or complete response after induction.

中文翻译：

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前体自体干细胞移植在患者诱导后应答中在外周T细胞淋巴瘤中的作用：来自LYSA中心的患者的分析。

背景技术外周T细胞淋巴瘤（PTCL）仍然是治疗上的挑战。由于PTCL的稀有性和异质性，即使对于一线治疗的类型也没有达成共识。因此，自体干细胞移植（ASCT）的益处仍在激烈辩论中。患者和方法在缺乏针对ASCT的作用的随机试验的情况下，我们进行了一项大型的多中心回顾性研究，并使用了多元比例风险模型和倾向评分匹配方法来校正分配给或不接受ASCT的患者之间的样本选择偏倚。意向治疗（ITT）。结果从法国，比利时和葡萄牙的14个中心筛查的527名患者中，最终队列的269名年龄≤65岁的PTCL（未另作说明）（NS）（N = 78，29％），血管免疫母细胞性T细胞淋巴瘤（AITL）（N = 123，46％）和间变性淋巴瘤激酶阳性间变性大细胞淋巴瘤（ALK-ALCL）（N = 68，25％）有部分（N = 52，19％）或确定了诱导后的完全反应（N = 217，81％），并在治疗开始前从病历中仔细收集了有关治疗分配的信息。在ITT中有134例患者被分配到ASCT，而没有135例。Cox多元模型（PFS的HR = 1.02; 95％CI：0.69-1.50; OS的HR = 1.08; 95％CI：0.68-1.69）或对潜在混杂因素进行严格匹配后的倾向得分分析（logrank P =对于PFS和OS，分别为0.90和0.66）发现了生存优势，有利于ASCT作为患者诱导后反应的巩固程序。亚组分析未显示患者根据反应状态，分期疾病或风险类别的任何进一步差异。结论目前的数据不支持将ASCT用于所有PTCL-NOS，AITL或ALK-ALCL患者，并在诱导后部分或完全缓解的情况下进行前期巩固。