{"id":15052,"date":"2021-06-07T08:47:02","date_gmt":"2021-06-07T06:47:02","guid":{"rendered":"https:\/\/convergences.online\/hemato\/?p=15052"},"modified":"2024-12-11T22:10:56","modified_gmt":"2024-12-11T21:10:56","slug":"autogreffe-vs-allogreffe-dans-le-lymphome-t-peripherique","status":"publish","type":"post","link":"https:\/\/www.hematostat.net\/en\/autogreffe-vs-allogreffe-dans-le-lymphome-t-peripherique\/","title":{"rendered":"Autogreffe vs allogreffe dans le lymphome T p\u00e9riph\u00e9rique"},"content":{"rendered":"

R\u00e9f. : HematoStat.net ; 2 (2) : R14<\/p>\n

A randomized phase 3 trial of autologous vs allogeneic transplantation as part of first-line therapy in poor-risk peripheral T-NHL<\/span><\/i><\/strong><\/div>\n
<\/div>\n
Schmitz, N. and al. A randomized phase 3 trial of autologous vs allogeneic transplantation as part of first-line therapy in poor-risk peripheral T-NHL. <\/span>Blood 137, 2646\u20132656 (2021).<\/i><\/a><\/div>\n
<\/div>\n
\n

R\u00e9sum\u00e9 :<\/strong><\/h3>\n

Une approche standard dans les lymphomes T p\u00e9riph\u00e9riques (LTP) de haut risque est d\u2019associer un traitement type CHO(E)P \u00e0 une intensification avec autogreffe. Cet essai de phase 3 proposait de randomiser en 1re <\/sup>ligne l\u2019autogreffe et l\u2019allogreffe. Cent-quatre patients ont \u00e9t\u00e9 inclus, apr\u00e8s un suivi m\u00e9dian de 42 mois, la survie sans progression \u00e0 3 ans \u00e9tait de 38 % (IC95 : 25-52 %) dans le groupe autogreffe contre 43 % (IC95 : 29-57 %) pour les allogreff\u00e9s.<\/p>\n

Dans nos pratiques :<\/strong><\/h3>\n

Survies comparables entre allo et autogreffes m\u00eame si on notera que parmi les 21 patients r\u00e9pondeurs qui ont b\u00e9n\u00e9fici\u00e9 d\u2019une allogreffe, aucun n\u2019a rechut\u00e9 (contre 36 % dans le groupe autogreffe). Une efficacit\u00e9 certaine mais qui est toutefois contrebalanc\u00e9e par une importante toxicit\u00e9. Une option th\u00e9rapeutique qui pourrait donc \u00eatre \u00e0 privil\u00e9gier en cas de rechute ou de chimior\u00e9sistance primaire.
\n<\/strong><\/p>\n

Le regard du statisticien :<\/strong><\/h3>\n

Cette phase 3 s\u2019est voulue tr\u00e8s prudente sur la randomisation des patients en usant d\u2019un algorithme sp\u00e9cifique, et des mod\u00e8les multivari\u00e9es int\u00e9grant les co-variables de stratification pour l\u2019ajustement. Les r\u00e9sultats sans appel : ils n\u2019ont pas montr\u00e9 de diff\u00e9rence en termes de survie (EFS, PFS et OS). Il est dommage que les r\u00e9sultats ne se soient pas davantage focalis\u00e9s sur la rechute et les d\u00e9c\u00e8s sans rechute (il manque les p-values sur les graphiques d\u2019incidence cumulative).
\n<\/strong><\/p>\n<\/div>\n<\/div><\/div><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":16,"featured_media":15053,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[36],"tags":[75,76,77],"ppma_author":[456],"class_list":["post-15052","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-revue-de-presse","tag-allogreffe-lymphome-t-peripherique","tag-autogreffe","tag-modeles-multivariees","author-alexis-genthon"],"aioseo_notices":[],"authors":[{"term_id":456,"user_id":16,"is_guest":0,"slug":"alexis-genthon","display_name":"Alexis GENTHON","avatar_url":{"url":"https:\/\/www.hematostat.net\/wp-content\/uploads\/2023\/06\/Capture-decran-2021-05-07-a-14.25.02.png","url2x":"https:\/\/www.hematostat.net\/wp-content\/uploads\/2023\/06\/Capture-decran-2021-05-07-a-14.25.02.png"},"first_name":"","last_name":"","user_url":"","description":"H\u00e9matologue.\r\nCorrespondance : H\u00f4pital Saint-Antoine \r\nService h\u00e9matologie clinique\r\n184 rue du Faubourg Saint-Antoine 75012 Paris."}],"_links":{"self":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/15052","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/users\/16"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/comments?post=15052"}],"version-history":[{"count":2,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/15052\/revisions"}],"predecessor-version":[{"id":18313,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/15052\/revisions\/18313"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/"}],"wp:attachment":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/media?parent=15052"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/categories?post=15052"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/tags?post=15052"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/ppma_author?post=15052"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}