N Schmitz

Asklepios Klinik St. Georg, Hamburg, Hamburg, Germany

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Publications (328)2246.06 Total impact

  • Norbert Schmitz · Huei Shan Wu
    Journal of Clinical Oncology 08/2015; DOI:10.1200/JCO.2015.63.1143 · 18.43 Impact Factor
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    ABSTRACT: We studied the influence of comorbidities on remission rate and overall survival (OS) in patients with chronic myeloid leukemia (CML). Participants of the CML-Study IV, a randomized five-arm trial designed to optimize imatinib therapy were analyzed for comorbidities at diagnosis using the Charlson Comorbidity Index (CCI). 511 indexed comorbidities were reported in 1519 CML patients. Age was an additional risk factor in 863 patients. Resulting CCI scores were: CCI 2: n=589, CCI 3 or 4: n=599, CCI 5 or 6: n=229, and CCI ≥ 7: n=102. No differences in cumulative incidences of accelerated phase, blast crisis, or remission rates were observed between patients in the different CCI groups. Higher CCI was significantly associated with lower OS probabilities. The 8-year OS probabilities were 93.6%, 89.4%, 77.6%, and 46.4%, for patients with CCI 2, 3-4, 5-6 and ≥ 7. In multivariate analysis, CCI was the most powerful predictor of OS, which was still valid after removal of its age-related components. Comorbidities have no impact on treatment success but do have a negative effect on OS indicating that survival of patients with CML is determined more by comorbidities than by CML itself. OS may therefore be inappropriate as outcome measure for specific CML treatments. Copyright © 2015 American Society of Hematology.
    Blood 04/2015; 126(1). DOI:10.1182/blood-2015-01-617993 · 10.43 Impact Factor
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    ABSTRACT: Extra-nodal NK/T lymphoma (ENKTL) is rare and more frequently encountered in East Asia. The role of high-dose therapy and autologous stem cell transplantation (HDT-ASCT) for ENKTL is unclear. Twenty-eight evaluable patients who had undergone HDT-ASCT in Europe from 2000-2009 were studied. The median age was 47 years and patients had received a median of 2 lines of prior therapy. 57% of patients were not in complete remission or beyond first complete remission at HDT-ASCT. The 1-year non-relapse mortality (NRM) was 11%. 2-year progression-free survival (PFS) and overall survival (OS) rates were 41% and 52% respectively. Notably, the 2-year PFS and OS for those with stage III/IV disease were 33% and 40% respectively, with no relapses beyond 1-year post-HDT-ASCT. This is the largest analysis of HDT-ASCT for patients with ENKTL reported from the Western hemisphere. Survival is comparable to East Asian cohorts and outcomes are encouraging for patients with advanced disease.
    Leukemia & lymphoma 04/2015; DOI:10.3109/10428194.2015.1037764 · 2.89 Impact Factor
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    ABSTRACT: Prognostically-relevant risk factors in patients with diffuse large B-cell lymphoma (DLBCL) have predominantly been evaluated in elderly populations. We tested whether previously described risk factors are also valid in younger, poor-prognosis DLBCL patients. Paraffin-embedded samples from 112 patients with de novo DLBCL, enrolled in the R-MegaCHOEP trial of the German High Grade Non-Hodgkin Lymphoma Study Group (DSHNHL) were investigated using immunohistochemistry (MYC, FOXP1, LMO2, GCET1, CD5, CD10, BCL2, BCL6, IRF4/MUM1) and fluorescence in situ hybridization (MYC, BCL2, BCL6). MYC, BCL2 and BCL6 breaks occurred in 14%, 21% and 31%, respectively. In the majority of cases, MYC was simultaneously rearranged with BCL2 and/or BCL6. The adverse impact of MYC rearrangements was confirmed, but the sole presence of BCL2 breaks emerged as a novel prognostic marker associated with inferior overall survival (OS) (p=0.002). Combined over-expression of MYC and BCL2 showed only limited association with inferior OS. All immunohistochemical cell of origin (COO) classifiers applied failed to predict survival time. DLBCL tumors with significant proportion of immunoblastic and/or immunoblastic-plasmacytoid cells had inferior OS, independently from from BCL2 break. Younger, poor-prognosis DLBCL patients, therefore, display different biological risk factors compared to an elderly population, with BCL2 translocations emerging as a powerful negative prognostic marker.Leukemia accepted article preview online, 17 February 2015. doi:10.1038/leu.2015.43.
    Leukemia 02/2015; 29(7). DOI:10.1038/leu.2015.43 · 9.38 Impact Factor
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    ABSTRACT: The presence of a mutated nucleophosmin-1 gene (NPM1mut) in acute myeloid leukemia (AML) is associated with a favorable prognosis. To assess the predictive value with regard to allogeneic stem-cell transplantation (SCT), we compared the clinical course of patients with NPM1mut AML eligible for allogeneic SCT in a donor versus no-donor analysis. Of 1,179 patients with AML (age 18 to 60 years) treated in the Study Alliance Leukemia AML 2003 trial, we identified all NPM1mut patients with an intermediate-risk karyotype. According to the trial protocol, patients were intended to receive an allogeneic SCT if an HLA-identical sibling donor was available. Patients with no available donor received consolidation or autologous SCT. We compared relapse-free survival (RFS) and overall survival (OS) depending on the availability of a suitable donor. Of 304 eligible patients, 77 patients had a sibling donor and 227 had no available matched family donor. The 3-year RFS rates in the donor and no-donor groups were 71% and 47%, respectively (P = .005); OS rates were 70% and 60%, respectively (P = .114). In patients with normal karyotype and no FLT3 internal tandem duplication (n = 148), the 3-year RFS rates in the donor and no-donor groups were 83% and 53%, respectively (P = .004); and the 3-year OS rates were 81% and 75%, respectively (P = .300). Allogeneic SCT led to a significantly prolonged RFS in patients with NPM1mut AML. The absence of a statistically significant difference in OS is most likely a result of the fact that NPM1mut patients who experienced relapse responded well to salvage treatment. Allogeneic SCT in first remission has potent antileukemic efficacy and is a valuable treatment option in patients with NPM1mut AML with a sibling donor. © 2014 by American Society of Clinical Oncology.
    Journal of Clinical Oncology 12/2014; 33(5). DOI:10.1200/JCO.2013.54.4973 · 18.43 Impact Factor
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    ABSTRACT: Salvage therapy followed by high-dose therapy (HDT) remains a mainstay for patients with relapsed lymphoma, however no optimal regimen has been defined. Here we report on the results of R-DexaBEAM (rituximab, dexamethasone, carmustine, etoposide, cytarabine, melphalan) followed by HDT. Patients aged 18–65 years, Eastern Cooperative Oncology Group performance score 0–2, with relapsed/refractory B-cell non-Hodgkin lymphoma (NHL) were eligible. R-Dexa-BEAM was given for two cycles followed by stem cell mobilization and HDT. Primary endpoint of the trial was progression-free-survival (PFS). One hundred and three patients were included: aggressive NHL (aNHL): diffuse large B-cell lymphoma 55, mantle cell lymphoma 7, follicular lymphoma (FL) grade 3: 5, indolent Lymphoma (iNHL): FL grade 1–2: 29, marginal zone lymphoma 6, Immunocytoma 1. The overall response rate after salvage therapy was 62% for aNHL and 78% for iNHL patients. 66% of patients with aNHL and 86% with iNHL underwent HDT. Treatment-related mortality for HDT was 1·3%. For aNHL patients, the median PFS was 0·83 years with 44% alive at the median follow-up of 7·3 years. Corresponding figures for iNHL were: median PFS 3·7 years and 72% alive after 8 years. The combination of rituximab with DexaBEAM followed by HDT resulted in high response rates and sustained remissions in responders. R-DexaBEAM followed by HDT can be considered a valid salvage option for NHL.
    British Journal of Haematology 12/2014; 168(6). DOI:10.1111/bjh.13234 · 4.96 Impact Factor
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    ABSTRACT: The optimal timing of allogeneic hematopoietic transplantation (HCT) in AML is controversial. We report on 1179 patients with a median age of 48 years who were randomized upfront. In the control arm, sibling HCT was scheduled in the first complete remission for intermediate-risk or high-risk AML and matched unrelated HCT in complex karyotype AML. In the experimental arm, matched unrelated HCT in the first remission was offered also to patients with an FLT3-ITD allelic ratio >0.8, poor day +15 marrow blast clearance, and adverse karyotypes. Further, allogeneic HCT was recommended in high-risk AML to be performed in aplasia after induction chemotherapy.Leukemia accepted article preview online, 01 December 2014. doi:10.1038/leu.2014.335.
    Leukemia 12/2014; 29(5). DOI:10.1038/leu.2014.335 · 9.38 Impact Factor
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    ABSTRACT: PURPOSE: To study pharmacokinetics, toxicity, and efficacy of prolonged rituximab exposure in elderly patients with diffuse large B-cell lymphoma (DLBCL). PATIENTS AND METHODS: In the SMARTE-R-CHOP-14 trial, rituximab 375 mg/m2 was administered, together with six cycles of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone on a 14-day schedule (6xR-CHOP-14), on days -4, 0, 10, 29, 57, 99, 155, and 239. Pharmacokinetics and outcome were to be compared with those of patients who had received 6xR-CHOP-14 in combination with eight 2-week applications of rituximab in the RICOVER-60 (Rituximab With CHOP Over Age 60 Years) trial. RESULTS: The complete response (CR)/unconfirmed CR rate was 85% in 189 evaluable patients, 90% for 90 good-prognosis patients (International Prognostic Index [IPI], 1 or 2), and 81% for 99 poor-prognosis patients (IPI, 3 to 5); 3-year event-free survival (EFS) was 71%, 75%, and 67%, respectively; and 3-year overall survival (OS) was 84%, 88%, and 80%, respectively, with no differences between men and women. The preplanned historical comparison with 306 RICOVER-60 patients (good prognosis, n = 183; poor prognosis, n = 123) revealed no outcome differences for all and good-prognosis patients; however, the longer exposure time in SMARTE-R-CHOP-14 compared with RICOVER-60 was associated with better 3-year EFS (67% v 54%) and OS (80% v 67%) in poor-prognosis patients. CONCLUSION: Extended rituximab exposure compared with eight 2-week applications in combination with 6xR-CHOP-14 significantly improved outcome of elderly poor-prognosis patients without increasing toxicity. To our knowledge, results obtained with the SMARTE-R-CHOP-14 rituximab schedule are the best reported for elderly patients with DLBCL to date. In the subgroup of poor-prognosis patients treated with extended rituximab exposure, the outcome seemed superior to that of a similar historical cohort of patients treated with 6xR-CHOP-14 plus 2-week rituximab, with similar toxicity. A randomized comparison of the two schedules is warranted.
    Journal of Clinical Oncology 11/2014; 32(36). DOI:10.1200/JCO.2013.54.6861 · 18.43 Impact Factor
  • N Schmitz · H S Wu · B Glaß
    DMW - Deutsche Medizinische Wochenschrift 10/2014; 139(41):2082-2085. DOI:10.1055/s-0034-1387290 · 0.55 Impact Factor
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    ABSTRACT: The objective of this registry study was to analyze the outcome of patients who underwent allogeneic or autologous hematopoietic stem cell transplantation (HSCT) for hepatosplenic T cell lymphoma (HSTL), a rare and extremely aggressive peripheral T cell lymphoma subtype. Patients were eligible if they had histologically verified HSTL and underwent HSCT between 2003 and 2011. 76 patients were identified in the EBMT database. Additional baseline and follow-up information could be obtained from the referring centres for 36 patients. Eleven of these were excluded following histopathology review, leaving 25 patients in the final study cohort (alloHSCT 18, autoHSCT 7). With a median follow-up of 36 months, 2 patients relapsed after alloHSCT, resulting in a 3-year progression-free survival of 48%. After autoHSCT, 5 patients relapsed and subsequently died. This study indicates that graft-versus-lymphoma activity conferred by alloHSCT can result in long-term survival for a substantial proportion of patients with HSTL.Leukemia accepted article preview online, 19 September 2014. doi:10.1038/leu.2014.280.
    Leukemia 09/2014; 29(3). DOI:10.1038/leu.2014.280 · 9.38 Impact Factor
  • Journal of Clinical Oncology 08/2014; 32(29). DOI:10.1200/JCO.2014.57.5597 · 18.43 Impact Factor
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    ABSTRACT: Leukemia is one of the leading journals in hematology and oncology. It is published monthly and covers all aspects of the research and treatment of leukemia and allied diseases. Studies of normal hemopoiesis are covered because of their comparative relevance.
    Leukemia 07/2014; 28(11). DOI:10.1038/leu.2014.213 · 9.38 Impact Factor
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    ABSTRACT: To define the role of radiotherapy and intrathecal prophylaxis in extralymphatic craniofacial involvement (ECFI) of aggressive B-cell lymphoma we analyzed 11 consecutive DSHNHL trials. ECFI occurred in 290/4155 (7.0%) patients (orbita: 31, paranasal sinuses: 93; main nasal cavity: 38, tongue: 27, remaining oral cavity: 99, salivary glands: 54). In a multivariable analysis adjusted for IPI rituximab improved EFS and OS both in patients with and without ECFI. Three-year event-free (79% vs 79%; p=0.842) and overall survival (86% vs. 88%; p=0.351) were similar in 145 patients receiving and 57 not receiving radiotherapy. Without rituximab, the 2-year cumulative rate of CNS disease was increased in 205 ECFI patients compared to 2586 non-ECFI patients (4.2% vs. 2.8%; p=0.038), while this was not observed with rituximab (1.6% in 83 ECFI vs 3.4% in 1252 non-ECFI patients; p=0.682). In 88 ECFI patients who received intrathecal prophylaxis with methotrexate, 2-year rate of CNS disease was 4.2% compared to 2.3% in 191 patients who did not (p=0.981). In conclusion, rituximab eliminates the increased risk for CNS disease in patients with ECFI. This retrospective analysis does not support intrathecal prophylaxis or radiotherapy to ECFI patients in CR/CRu. These findings should be confirmed in a prospective study.
    Blood 06/2014; 124(5). DOI:10.1182/blood-2013-10-535021 · 10.43 Impact Factor
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    ABSTRACT: Background: To improve outcome of elderly patients with diffuse large B-cell lymphoma, dose-dense rituximab was evaluated in the prospective DENSE-R-CHOP-14 trial. Patients and methods: Rituximab (375 mg/m(2)) was given on days 0, 1, 4, 8, 15, 22, 29, 43, 57, 71, 85, and 99 together with six CHOP-14 cycles. Results were to be compared with patients who had received the same chemotherapy in combination with eight 2-week applications of rituximab in RICOVER-60. Results: One hundred twenty-four patients are assessable. Dose-dense rituximab resulted in considerably higher serum levels during the first 50 days of treatment, but rituximab exposure time was not prolonged. Grade 3 and 4 infections were exceptionally high in the first 20 patients without anti-infective prophylaxis, but decreased after introduction of prophylaxis with aciclovir and cotrimoxazole in the remaining 104 patients (from 13% to 6% per cycle and from 35% to 18% per patient; P = 0.007 and P = 0.125, respectively). Patients with international prognostic index = 3-5 had higher complete response/ complete response unconfirmed rates (82% versus 68%; P = 0.033) than in the respective RICOVER-60 population, but this did not translate into better long-term outcome, even though male hazard was decreased (event-free survival: from 1.5 to 1.1; progression-free survival: from 1.7 to 1.1; overall survival: from 1.4 to 1.0). Conclusions: Dose-dense rituximab achieved higher rituximab serum levels, but was not more effective than eight 2-week applications in the historical control population, even though minor improvements in poor-prognosis and male patients cannot be excluded. The increased, though manageable toxicity, precludes its use in routine practice. Our results strongly support anti-infective prophylaxis with aciclovir and cotrimoxazole for all patients receiving R-CHOP.
    Annals of Oncology 06/2014; 25(9). DOI:10.1093/annonc/mdu208 · 6.58 Impact Factor
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    ABSTRACT: Allogeneic stem-cell transplantation has had limited success for patients with refractory and relapsed aggressive B-cell or T-cell lymphoma. We investigated the effect of adding rituximab to standard prophylaxis for graft-versus-host disease after transplantation and estimated overall survival when using a lymphoma-directed myeloablative conditioning regimen. We did this randomised, open-label, phase 2 study at seven German transplantation centres. We enrolled patients with aggressive B-cell or T-cell lymphoma and primary refractory disease, early relapse (<12 months after first-line treatment), or relapse after autologous transplantation. Conditioning with fludarabine (125 mg/m(2)), busulfan (12 mg/kg oral or 9·6 mg/kg intravenous), and cyclophosphamide (120 mg/kg) was followed by allogeneic stem-cell transplantation. Patients were randomly assigned (1:1) to receive rituximab (375 mg/m(2) on days 21, 28, 35, 42, 175, 182, 189, and 196) or not. Allocation was done with a centralised computer-generated procedure; patients were stratified by histological subtype (B-cell vs T-cell lymphoma) and donor match (HLA-identical vs non-identical). Neither investigators nor patients were masked to allocation. The primary endpoints were the incidence of acute graft-versus-host disease grade 2-4 in each treatment group and overall survival at 1 year in both groups combined. All analyses were done for the intention-to-treat population. The study is registered with ClinicalTrials.gov, number NCT00785330. Between June 16, 2004, and March 24, 2009, we screened 86 patients and enrolled 84; 42 were randomly assigned to each group. The cumulative incidence of grade 2-4 acute graft-versus-host disease was 46% (95% CI 32-62) in the rituximab group and 42% (95% CI 29-59) in the no rituximab group (hazard ratio [HR] 0·91, 95% CI 0·52-1·60; p=0·74). Overall survival at 1 year for the whole study population was 52% (95% CI 41-62). Grade 4 haematological toxic effects and grade 3 alopecia occurred in all patients. The most common non-haematological grade 5 toxic effects were pneumonia (nine in the no rituximab group vs ten in the rituximab group) and other infections (seven vs four). The lymphoma-directed myeloablative conditioning regimen developed here is promising for patients with refractory and relapsed aggressive B-cell and T-cell lymphomas. However, the addition of rituximab did not affect the incidence of graft-versus-host disease or overall survival. Hoffmann-La Roche, Amgen, Astellas Pharma.
    The Lancet Oncology 05/2014; 15(7). DOI:10.1016/S1470-2045(14)70161-5 · 24.73 Impact Factor
  • Anna Sureda · E Domenech · N Schmitz · P Dreger
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    ABSTRACT: The treatment of patients with classical Hodgkin's lymphoma relapsing after autologous stem cell transplantation represents a clear unmet need. Overall long-term outcome is not the same in these patients and therapeutic options in this setting are very heterogeneous and include salvage CT and/or RT followed or not by a second stem cell transplantation, palliative care, new drugs, or biological agents. Despite the absence of prospective, randomized, clinical trials, allogeneic stem cell transplantation either from a HLA identical sibling or a matched, unrelated donor represents an attractive option for those young patients with chemosensitive disease after being treated with a salvage protocol. The use of reduced intensity conditioning regimens has been able to drastically decrease nonrelapse mortality, although relapse rate remains a significant issue in this setting. More intense conditioning protocols could eventually decrease the relapse rate after the allogeneic procedure and, as indicated by a recent retrospective analysis of the Lymphoma Working Party of the European Group for Blood and Marrow Transplantation, nonrelapse mortality does not represent a major problem nowadays for patients with multiply relapsed Hodgkin's lymphoma. Brentuximab vedotin is an antibody-drug conjugate that selectively delivers monomethyl auristatin E, an antimicrotubule agent, into CD30-expressing cells. Its use has been approved recently for patients with Hodgkin's lymphoma relapsing after autologous stem cell transplantation. As a single dose, brentuximab vedotin is able to achieve an objective response rate of 75 % with 34 % of the patients achieving a complete remission. Its widespread use will most certainly change the treatment paradigm of this subgroup of patients, either avoiding the allogeneic procedure in some patients or by increasing the group of potential candidates to an allogeneic transplant being used as a "bridge to allo." Additional information on long-term outcome of patients being treated with this drug or the development of prospective clinical trials in this setting will most probably give some light to this question we have nowadays.
    Current Treatment Options in Oncology 04/2014; 15(2). DOI:10.1007/s11864-014-0287-3 · 3.24 Impact Factor
  • Norbert Schmitz · Marita Ziepert · Umberto Vitolo
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    ABSTRACT: To the Editor: Stiff et al. (Oct. 31 issue)(1) report that autologous stem-cell transplantation improved progression-free survival among patients with high-intermediate-risk or high-risk aggressive non-Hodgkin's lymphoma who had a response to induction therapy. This statement has limited clinical value because it does not translate into a survival advantage; moreover, only 150 patients in the study received cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) plus rituximab (R-CHOP). The estimated 2-year progression-free survival among these patients was 63% in the control group and 73% in the transplantation group (hazard ratio, 1.56; 95% confidence interval [CI], 0.92 to 2.63; P=0.10). This 10-percentage-point difference in ...
    New England Journal of Medicine 02/2014; 370(6):574-5. DOI:10.1056/NEJMc1314757#SA1 · 54.42 Impact Factor
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    ABSTRACT: R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone) is standard care for aggressive B-cell lymphoma. A prospective trial was conducted to investigate the role of additive radiotherapy (RT) to bulky and extralymphatic disease. The best arm of the RICOVER-60 trial (6×R-CHOP-14+2R [R-CHOP administered once every 2 weeks plus two additional applications of rituximab] plus involved-field RT [36 Gy] to sites of initial bulky [≥ 7.5 cm] disease and extralymphatic involvement) was compared with a cohort receiving the same immunochemotherapy but without RT in an amendment to the RICOVER-60 trial (RICOVER-noRTh) in a prospective fashion. After a median observation time of 39 months, 164 of 166 RICOVER-noRTh patients were evaluable. In a multivariable analysis of the intention-to-treat population adjusting for International Prognostic Index risk factors and age (> 70 years), event-free survival (EFS) of patients with bulky disease was inferior without additive RT (hazard ratio [HR], 2.1; 95% CI, 1.3 to 3.5; P = .005), with trends for inferior progression-free (PFS; HR, 1.8; 95% CI, 1.0 to 3.3; P = .058) and overall survival (OS; HR, 1.6; 95% CI, 0.9 to 3.1; P = .127). In a per-protocol analysis with 11 patients in RICOVER-noRTh excluded for receiving unplanned RT, multivariable analysis revealed HRs of 2.7 (95% CI, 1.3 to 5.9; P = .011) for EFS, 4.4 (95% CI, 1.8 to 10.6; P = .001) for PFS, and 4.3 (95% CI, 1.7 to 11.1; P = .002) for OS for patients not receiving RT to bulky disease. Additive RT to bulky sites abrogates bulky disease as a risk factor and improves outcome of elderly patients with aggressive B-cell lymphoma. Whether RT can be spared in patients with (metabolic) complete remission after immunochemotherapy must be addressed in appropriately designed prospective trials.
    Journal of Clinical Oncology 02/2014; 32(11). DOI:10.1200/JCO.2013.51.4505 · 18.43 Impact Factor
  • Norbert Schmitz · Huei-Shan Wu · Bertram Glass
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    ABSTRACT: Except for ALK-positive anaplastic large cell lymphoma (ALCL) and patients with limited disease, mature T- and natural killer (NK) cell lymphomas are disorders with a poor prognosis. Patients with relapsed or refractory ALK-negative ALCL, angioimmunoblastic T-cell lymphoma (AITL), or peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS) after allogeneic transplantation of hematopoietic stem cells (alloSCT) achieve long-term survival in 35%-50% of cases. Survival in patients with less frequent subtypes (NK/T-cell lymphoma, cutaneous T-cell lymphomas, acute T-cell leukemia/lymphoma, or hepatosplenic T-cell lymphoma) also seems promising. These results are significantly better than those of any other treatment modality, including the new drugs. Therefore, alloSCT should be considered in patients with relapsed/ refractory T-cell lymphoma. Because of low patient numbers and lack of comparative studies, the optimum conditioning regimen prior to transplantation as well as other details of the transplant procedure remain unknown and await further study. Studies investigating the role of alloSCT as part of first-line therapy in poor-risk T-cell lymphomas are ongoing. At present, data are not sufficient to recommend alloSCT outside of clinical trials.
    Seminars in Hematology 01/2014; 51(1):67-72. DOI:10.1053/j.seminhematol.2013.11.010 · 2.46 Impact Factor
  • Ash 2013; 12/2013

Publication Stats

12k Citations
2,246.06 Total Impact Points

Institutions

  • 2008–2015
    • Asklepios Klinik St. Georg
      Hamburg, Hamburg, Germany
    • Carl Gustav Carus-Institut
      Pforzheim, Baden-Württemberg, Germany
  • 2013
    • Aichi Medical University
      • Department of Promotion for Blood and Marrow Transplantation
      Okazaki, Aichi, Japan
  • 2010
    • University of Milan
      Milano, Lombardy, Italy
    • Uppsala University
      Uppsala, Uppsala, Sweden
    • University of Rome Tor Vergata
      Roma, Latium, Italy
    • Radboud University Nijmegen
      Nymegen, Gelderland, Netherlands
    • University of Leipzig
      • Institute of Medical Informatics, Statistics and Epidemiology
      Leipzig, Saxony, Germany
  • 1997–2008
    • University of Cologne
      • Department of Internal Medicine
      Köln, North Rhine-Westphalia, Germany
  • 2003–2007
    • Klinikum St. Georg Leipzig
      Leipzig, Saxony, Germany
    • Klinik St. Georg
      Albling, Bavaria, Germany
    • University of Nebraska Medical Center
      Omaha, Nebraska, United States
  • 2006
    • Technische Universität München
      München, Bavaria, Germany
    • Universitätsmedizin Göttingen
      • Department of Hematology and Oncology
      Göttingen, Lower Saxony, Germany
  • 2000–2006
    • Medical College of Wisconsin
      • Center for International Blood & Marrow Transplant Research
      Milwaukee, Wisconsin, United States
  • 2002
    • St. Bernward Krankenhaus in Hildesheim
      Hildesheim, Lower Saxony, Germany
  • 1982–2002
    • Christian-Albrechts-Universität zu Kiel
      • UKSH II. Medizinische Klinik und Poliklinik
      Kiel, Schleswig-Holstein, Germany
  • 2001
    • University of Southampton
      Southampton, England, United Kingdom
  • 1999
    • Felix Platter Hospital
      Bâle, Basel-City, Switzerland
    • The Bracton Centre, Oxleas NHS Trust
      Дартфорде, England, United Kingdom
    • University of Nottingham
      Nottigham, England, United Kingdom
  • 1996
    • Universität Heidelberg
      Heidelburg, Baden-Württemberg, Germany
  • 1990
    • University of Iowa Children's Hospital
      Iowa City, Iowa, United States
  • 1984
    • HELIOS Klinik Kiel
      Kiel, Schleswig-Holstein, Germany
  • 1981
    • Justus-Liebig-Universität Gießen
      Gieben, Hesse, Germany