Bone marrow transplantation for peripheral T-cell lymphoma in children and
adolescents
BG Gordon, PI Warkentin, DD Weisenburger, JM Vose, WG Sanger, SE Strandjord, JR Anderson, JD Verdirame, PJ Bierman and JO Armitage
Department of Pediatrics, University of Nebraska Medical Center, Omaha
68198-2165.
We report nine children with relapsed (n = 8) or high-risk (n = 1)
peripheral T-cell lymphoma (PTCL) who underwent autologous (n = 6) or
allogeneic (n = 3) bone marrow transplantation (BMT). These children
received transplants as part of a prospective phase I/II study of thioTEPA
(TT) and total body irradiation (TBI) with escalating doses of VP-16. The
median age of these patients at time of BMT was 6.5 years (range 2.5 years
to 14 years). Three were transplanted with active disease after failing
salvage chemotherapy. Of the other six, one was transplanted in first
complete remission (CR) and five in second or subsequent CR. Of these nine
patients, eight are free of disease a median of 25 months after BMT (range,
6 to 48 months), with an estimated 2-year relapse-free survival (RFS) of
89%. Six of these eight patients have been followed for 12 or more months
after BMT, and in each their current remission exceeds their longest
previous remission duration. The toxicity of the TT/TBI +/- VP-16 regimens
was significant but manageable, predominantly consisting of severe
mucositis. For a comparison, we reviewed retrospective data on the six
additional children and adolescents with PTCL who underwent BMT during the
3-year period preceding this phase I/II study. The median age at BMT of
these six patients was 19 years (range 15.5 years to 20 years). These
patients were prepared for BMT with a variety of other regimens. One had no
response to BMT and the other five relapsed at 1.5 to 5 months after BMT
(median, 3 months) with an RFS of 0%. Our data suggest that thioTEPA plus
TBI, with or without VP-16, is an effective preparative regimen for BMT for
young patients with relapsed or high-stage PTCL and leads to prolonged RFS.
Volume 80,
Issue 11,
pp. 2938-2942,
12/01/1992
Copyright © 1992 by The American Society of Hematology
