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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Hematologic Malignancies
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1461268

DL-ICE as a Bridge to Allogeneic Transplantation in Relapsed/Refractory PTCL: Survival Outcomes and Prognostic Factors

Provisionally accepted
Tong Yoon Kim Tong Yoon Kim 1Tae-Jung Kim Tae-Jung Kim 2Eun Ji Han Eun Ji Han 3Gi June Min Gi June Min 4Seok-Goo Cho Seok-Goo Cho 4Youngwoo Jeon Youngwoo Jeon 4*
  • 1 Department of Hematology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Seoul, Republic of Korea
  • 2 Department of Hospital Pathology, Yeouido St. Mary's hospital, The Catholic University of Korea, Seoul, Republic of Korea, Seoul, Republic of Korea
  • 3 Division of Nuclear Medicine, Department of Radiology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Seoul, Republic of Korea
  • 4 Department of Hematology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Seoul, Republic of Korea

The final, formatted version of the article will be published soon.

    Peripheral T-cell lymphomas (PTCLs) have poor outcomes in the relapsed/refractory (R/R) setting. In this study, we evaluated the efficacy of dexamethasone, L-asparaginase, ifosfamide, carboplatin, and etoposide (DL-ICE) chemotherapy followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with R/R PTCLs. Methods: We retrospectively analyzed 80 adult patients with R/R PTCLs treated with DL-ICE chemotherapy between September 2009 and March 2023. Patients achieving complete or partial remission were eligible for consolidative allo-HSCT. Overall survival (OS) and progression-free survival (PFS) were evaluated. Results: The overall response rate to DL-ICE was 37.5%, with 30% achieving complete remission (CR). With a median follow-up of 96.4 months, the median OS and PFS were 8.9 and 3.8 months, respectively. Seventeen patients (21%) underwent allo-HSCT, including 11 with non-CR status. The 5-year OS was significantly higher in the allo-HSCT group compared to that in the group with chemotherapy alone (64.7% vs 18.3%, p <0.001). Multivariate analysis identified advanced stage, EBV viremia, and non-CR status as poor prognostic factors. Discussion: DL-ICE chemotherapy demonstrated modest activity in R/R PTCLs. Consolidation with allo-HSCT, even in patients who do not achieve CR, resulted in long-term survival in a subset of patients. Early consideration of allo-HSCT may improve outcomes for patients with R/R PTCLs.

    Keywords: L-asparaginase, Non-Hodgkin lymphomas, Relapsed/refractory, Stem Cell Transplantation, T-cell lymphomas

    Received: 08 Jul 2024; Accepted: 21 Nov 2024.

    Copyright: © 2024 Kim, Kim, Han, Min, Cho and Jeon. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Youngwoo Jeon, Department of Hematology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Seoul, Republic of Korea

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