Long-Term Follow-Up of the Prospective Randomized AATT Study (Autologous or Allogeneic Transplantation in Patients With Peripheral T-Cell Lymphoma)

<i>Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in</i> JCO <i>or elsewhere, for which the primary end point has already been reported.</i>Primary analysis of the phase III randomized AATT study showed that younger patients with peripheral T-cell lymphoma (PTCL) consolidated with autologous or allogeneic transplantation (alloSCT) had similar event-free survival (EFS) and overall survival (OS). Seven-year EFS of patients randomly assigned to alloSCT was 38% (95% CI, 25 to 52) compared with 34% (95% CI, 22 to 47) for patients randomly assigned to autologous transplantation of hematopoietic stem cells (autoSCT); OS was 55% (95% CI, 41 to 69) and 61% (95% CI, 47 to 74). Among patients undergoing alloSCT (n = 26) or autoSCT (n = 41) on study, the cumulative progression/relapse rate was 8% (95% CI, 0 to 19) and 55% (95% CI, 35 to 74). Nonrelapse mortality (NRM) was 31% (95% CI, 13 to 49) and 3% (95% CI, 0 to 8) after alloSCT and autoSCT, respectively. Fifteen of 30 patients with early progression and 11 of 20 patients with progression/relapse after autoSCT received alloSCT. Seven-year OS after salvage alloSCT was 61% (95% CI, 47 to 74); NRM was 23% (95% CI, 6 to 40). Long-term follow-up documents the strong graft versus 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 PTCL. AlloSCT is currently not recommended as part of first-line consolidation.

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Publication Details

Journal
Journal of Clinical Oncology
Published
2024-09-13
DOI
https://doi.org/10.1200/jco.24.00554
Citations
13
Primary Topic
T-cell and Retrovirus Studies
Type
article
Field-Weighted Citation Impact
3.13
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article

Long-Term Follow-Up of the Prospective Randomized AATT Study (Autologous or Allogeneic Transplantation in Patients With Peripheral T-Cell Lymphoma)

Norbert Schmitz, Laurence Sanhès, Mathias Haenel, Marie Robin et al.
13 citations
Journal of Clinical Oncology
T-cell and Retrovirus Studies
3.13
article

Long-Term Follow-Up of the Prospective Randomized AATT Study (Autologous or Allogeneic Transplantation in Patients With Peripheral T-Cell Lymphoma)

Norbert Schmitz, Laurence Sanhès, Mathias Haenel, Marie Robin, Philippe Gaulard, Birte Friedrichs, Viola Poeschel, Pascal Turlure, Ulrich Bernd Keller, Gerald Wulf, Roch Houot, Guillaume Cartron, Eva Wagner-Drouet, Murielle Roussel, Georg Lenz, Marita Ziepert, Éric Durot, Martin H. Dreyling, Andreas Rosenwald, Bettina Altmann, Jérôme Cornillon, Olivier Tournilhac, Gandhi Laurent Damaj, Andreas Viardot, Mathieu Leclerc, Bernard Drénou, Ahmet Elmaağaclı, Laurence de Leval, Frank Kroschinsky, Maike Nickelsen, Peter Dreger, David Sibon, Alban Villate, Christelle Latiere, Stéphanie Nguyen, Bertram Glass, Peter Reimer, Kamal Bouabdallah, Karin Bilger, Mourad Tiab, Anne Banos, Lorenz Trümper
article en
13 citations

Abstract

<i>Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in</i> JCO <i>or elsewhere, for which the primary end point has already been reported.</i>Primary analysis of the phase III randomized AATT study showed that younger patients with peripheral T-cell lymphoma (PTCL) consolidated with autologous or allogeneic transplantation (alloSCT) had similar event-free survival (EFS) and overall survival (OS). Seven-year EFS of patients randomly assigned to alloSCT was 38% (95% CI, 25 to 52) compared with 34% (95% CI, 22 to 47) for patients randomly assigned to autologous transplantation of hematopoietic stem cells (autoSCT); OS was 55% (95% CI, 41 to 69) and 61% (95% CI, 47 to 74). Among patients undergoing alloSCT (n = 26) or autoSCT (n = 41) on study, the cumulative progression/relapse rate was 8% (95% CI, 0 to 19) and 55% (95% CI, 35 to 74). Nonrelapse mortality (NRM) was 31% (95% CI, 13 to 49) and 3% (95% CI, 0 to 8) after alloSCT and autoSCT, respectively. Fifteen of 30 patients with early progression and 11 of 20 patients with progression/relapse after autoSCT received alloSCT. Seven-year OS after salvage alloSCT was 61% (95% CI, 47 to 74); NRM was 23% (95% CI, 6 to 40). Long-term follow-up documents the strong graft versus 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 PTCL. AlloSCT is currently not recommended as part of first-line consolidation.

Journal of Clinical OncologyVol. 42(32)
Inserm (FR), Université Paris-Est Créteil (FR), Université Clermont Auvergne (FR), Heidelberg University (DE), University Hospital Heidelberg (DE), Centre Hospitalier Universitaire de Bordeaux (FR), Sorbonne Université (FR), Centre Hospitalier de Perpignan (FR), Sorbonne Paris Cité (FR), Centre Hospitalier Universitaire de Montpellier (FR), Centre Hospitalier Universitaire de Tours (FR), Assistance Publique – Hôpitaux de Paris (FR), Institut universitaire du cancer de Toulouse Oncopole (FR), Comprehensive Cancer Center Mainfranken (DE), University Hospital Münster (DE), Roche (France) (FR), Pitié-Salpêtrière Hospital (FR), Asklepios Klinik St. Georg (DE), Hôpital Robert-Debré (FR), Centre Hospitalier de la Côte Basque (FR), Hôpital Universitaire Dupuytren (FR), Laboratoire d’HYdrologie et de GEochimie (FR), Hôpital Saint-Louis (FR), Hôpitaux Universitaires de Strasbourg (FR), Kliniken Essen-Mitte (DE), Centre Hospitalier Départemental Vendée (FR), Groupe Hospitalier de la Région de Mulhouse et Sud Alsace (FR), University Hospital Ulm (DE), Centre Hospitalier Universitaire de Rennes (FR), Helios Hospital Berlin-Buch (DE), Centre Hospitalier Universitaire de Saint-Étienne (FR), Hôpital Dupuytren (FR), Klinikum Chemnitz (DE), Université de Rennes (FR), Technical University of Munich (DE), University of Göttingen (DE), Ludwig-Maximilians-Universität München (DE), Saarland University (DE), Leipzig University (DE), University of Lausanne (CH), Université de Caen Normandie (FR)
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Openalex Percentile: Top 8%
T-cell and Retrovirus Studies
3.13
DOIOpen Access PDFOpenAlex
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