Lymphoma, T-Cell, Peripheral Clinical Trial
Official title:
Intensive Chemo-immunotherapy as First-line Treatment in Adult Patients With Peripheral T-cell Lymphoma (PTCL)
Peripheral T cell lymphomas (PTCL) are a rare hematologic disease. Five-year overall
survival (OS) of PTCL patients (pts) ranges between 20 and 30%. Allogeneic stem cell
transplantation (allo-STC) may have a curative role for these pts but its toxicity is high
when myeloablative conditioning is used. Reduced intensity conditionings (RIC) can decrease
transplant related toxicity and mortality. The investigators have recently proved
feasibility and potential efficacy of a RIC regimen in relapsed PTCL patients.
We want to investigate whether it is possible to improve the outcome of alk negative PTCL
pts, stage II-IV at diagnosis, by intensifying the therapeutic approach.
The intensification will be obtained by combining intensive chemotherapy, alemtuzumab
(anti-CD52 humanised antibody) and auto- or allo-SCT in pts aged between 18 and 60 years
(Clinical Study A) or adding alemtuzumab to standard chemotherapy (CHOP) in pts aged between
61 and 70 years(Clinical Study B).
Inclusion criteria Clin A
- Age ≥18 < or =60 years (patients older than 60 years are excluded because of the
intensive chemotherapy and transplant procedures)
- Histologically proven diagnosis of PTCL, including the following categories: PTCL-U
(peripheral T-cell lymphoma, unspecified), AILD-T (angioimmunoblastic-like T-cell
lymphoma), ALKneg ALCL (ALK-negative anaplastic large cell lymphoma),intestinal T - NHL
- Advanced stage disease (stage II-IV) or stage I and aaIPI score ≥ 2
- Written informed consent
Inclusion criteria Clin B
- Age >60 and ≤75 years (patients older than 75 years are excluded because of the
intensive chemo-immunotherapy program)
- Histological proven diagnosis of PTCL, including the following categories: PTCL-U
(peripheral T-cell lymphoma, unspecified), AILD-T (angioimmunoblastic-like T-cell
lymphoma), ALKneg ALCL (ALK-negative anaplastic large cell lymphoma), intestinal T -
NHL
- Advanced-stage disease (stage II-IV) or stage I and aaIPI score ≥ 2
- Informed written consent
In clinical study A (Clin A) we are planning to evaluate the efficacy and the feasibility of
an intensified chemo-immunotherapy program including auto-SCT or RIC allo-SCT in advanced
stage PTCL pts ≥ 18 and < or = 60 years.
In clinical study B (Clin B) we intend to verify the efficacy and the feasibility of a
combined immuno-chemotherapy approach in a subset of elderly pts aged > 60 and < or = 75
years.
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Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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