CEAC, BEAM and IEAC high-dose chemotherapy followed by autologous stem cell transplantation in peripheral T-cell lymphoma patients: A single center comparative analysis of efficacy and safety

Autologous stem cell transplantation (ASCT) is an important treatment for Peripheral T-cell lymphoma (PTCL) patients both during front and salvage therapy. We retrospectively compared the outcomes of 52 PTCL patients treated with CEAC (n=28), BEAM (n=14) and IEAC (n=10) regimens followed by ASCT at our center between 2012 and 2021. Although the time of neutrophil engraftment in CEAC group was earlier than that in IEAC group ( P =0.042) and platelet infusion in BEAM group was significantly more than CEAC group ( P =0.042), there were no significant difference in platelet engraftment, hematopoietic engraftment and red blood cells infusion among the 3 groups. The transplantation related mortality rate (TRM) and the early overall response rate (ORR) was 3.8% and 85.7% respectively. The 5-year OS and PFS was 62.8% (95% CI: 54.8%-70.8%) and 61.0% (95% CI: 53.1%-68.9%) respectively. There was no significant difference in TRM, ORR and survival among the 3 groups. Univariate and multivariate analysis showed that high PIT score (＞1) and non-CR at 3 months after ASCT were common risk factors for OS ( P =0.036 and 0.007) and PFS ( P =0.021 and 0.012). In conclusion, CEAC and IEAC regimen can be used as alternative conditioning regiments for ASCT in PTCL patients, and their efficacy and safety are comparable to BEAM regiment. Patients with high PIT score and failure to reach CR early after ASCT had worse outcomes.