Role of Stem Cell Transplant in CD30-positive PTCL following Frontline Brentuximab Vedotin+CHP or CHOP in ECHELON-2. Blood advances Savage, K. J., Horwitz, S. M., Advani, R., Christensen, J. H., Domingo-Domenech, E., Rossi, G., Morschhauser, F., Alpdogan, O., Suh, C., Tobinai, K., Shustov, A., Trneny, M., Yuen, S. L., Zinzani, P. L., Truemper, L. H., Illidge, T. M., O'Connor, O. A., Pro, B., Miao, H., Bunn, V., Fenton, K., Fanale, M., Puhlmann, M., Iyer, S. P. 2022


Peripheral T-cell lymphomas (PTCLs) are a heterogeneous group of aggressive non-Hodgkin lymphomas, the majority of which have a high relapse rate following standard therapy. Despite use of consolidative stem cell transplant (SCT) following frontline therapy, there remains no consensus on its utility. The double blind randomized phase 3 ECHELON-2 study (NCT01777152) demonstrated an improved progression-free survival (PFS) and overall survival with frontline brentuximab vedotin plus cyclophosphamide, doxorubicin, and prednisone (A+CHP). Herein, we conducted an exploratory subgroups analysis of the impact of consolidative SCT on PFS in patients with previously untreated, CD30-positive PTCL (ALK-negative anaplastic large cell lymphoma [ALCL] and non-ALCL) who were in complete response (CR) at end of treatment with frontline A+CHP or CHOP. Median PFS follow-up was 47.57 months (95% CI, 41.89-48.16). The PFS hazard ratio was 0.36 (95% CI, 0.17-0.77), equating to an 64% reduction in the risk of a PFS event in patients who underwent SCT. The median PFS in patients who underwent SCT was not reached (95% CI, 49.81, NA), versus 55.66 months (95% CI, 19.88, NA) in patients who did not undergo SCT. PFS results favored the use of SCT in both ALK-negative ALCL and non-ALCL subgroups. These data support the consideration of consolidative SCT in patients with CD30-positive PTCL who achieve a CR following treatment with A+CHP.

View details for DOI 10.1182/bloodadvances.2020003971

View details for PubMedID 35470385