推荐对新被诊断为外周T细胞淋巴瘤（PTCL）的患者进行前期自体干细胞移植（ASCT），而基于蒽环类化疗药物（如环磷酰胺、阿霉素、长春新碱和泼尼松）的CHO（CHOP）方案则是PTCL的一线化疗手段。然而，蒽环类化疗方案如CHOP能否成为PTCL的标准诱导治疗尚不清楚。我们进行了一项随机二期研究，比较了适用于ASCT的CHOP和分割的异膦酸异丁酯、卡铂、异环磷酰胺和地塞米松（ICED）两种方案。主要终点是无进展生存期（PFS），次要终点包括客观缓解率、总生存期（OS）和安全性。患者被随机分为CHOP组（n = 69）和ICED组（n = 66），两组特征没有差异。PTCL-未特指（NOS，n = 60）和血管免疫母细胞性T细胞淋巴瘤（AITL，n = 53）占据了主导地位。CHOP组和ICED组的客观缓解率没有差异，3年PFS在CHOP组（36.7%）和ICED组（33.1%）之间也没有显著差异。在AITL患者中，CHOP方案优于ICED方案，而ICED方案则与更多的细胞减少和剂量降低相关。在CHOP或ICED治疗后达到完全缓解的患者接受前期ASCT的3年总生存率为80%。总之，我们的研究表明，从响应和PFS方面来看，CHOP和ICED之间没有治疗差异。因此，对于AITL的患者，尤其是基于AITL患者疗效更好的原因，CHOP可能仍然是参考方案，并且前期ASCT可以作为PTCL患者完全缓解的巩固治疗的推荐方法。 版权所有 © 2023年Kim, Jo, Yoon, Yang, Yoon, Lee, Kong, Park, Kang, Lee, Oh, Shin, Lee, Choi, Jeong, Kim, Kang, Yi, Lim, Yhim, Do, Yun, Eom, Lee, Suh和Kim。

Upfront autologous stem cell transplantation (ASCT) has been recommended for patients who are newly diagnosed with peripheral T-cell lymphoma (PTCL), and CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone), an anthracycline-based chemotherapy has been the frontline chemotherapy for PTCL. However, it is not clear whether anthracycline-based chemotherapies such as CHOP could be standard induction therapy for PTCL.We conducted a randomized phase II study to compare CHOP with fractionated ifosfamide, carboplatin, etoposide, and dexamethasone (ICED) for patients eligible for ASCT. The primary endpoint was progression-free survival (PFS) and secondary endpoints included objective response rate, overall survival (OS), and safety profiles.Patients were randomized into either CHOP (n = 69) or ICED (n = 66), and the characteristics of both arms were not different. PTCL-not otherwise specified (NOS, n = 60) and angioimmunoblastic T-cell lymphoma (AITL, n = 53) were dominant. The objective response rate was not different between CHOP (59.4%) and ICED (56.1%), and the 3-year PFS was not different between CHOP (36.7%) and ICED (33.1%). In AITL patients, CHOP was favored over ICED whereas ICED was associated with more cytopenia and reduced dose intensity. Patients who received upfront ASCT after achieving complete response to CHOP or ICED showed 80% of 3-year OS.In summary, our study showed no therapeutic difference between CHOP and ICED in terms of response and PFS. Thus, CHOP might remain the reference regimen especially for AITL based on its better outcome in AITL, and upfront ASCT could be recommended as a consolidation of complete response in patients with PTCL.Copyright © 2023 Kim, Jo, Yoon, Yang, Yoon, Lee, Kong, Park, Kang, Lee, Oh, Shin, Lee, Choi, Jeong, Kim, Kang, Yi, Lim, Yhim, Do, Yun, Eom, Lee, Suh and Kim.