***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: AIM To analyze toxicity , response and outcome of a phase II trial with intensive chemotherapy plus autologous stem-cell transplantation ( ASCT ) for young patients with peripheral T-cell lymphoma ( PTCL ) . PATIENTS AND METHODS Forty-one patients [ 30 males and 11 females , median age 47 years ] consecutively diagnosed with PTCL received three courses of high-dose cyclophosphamide 2000 mg/m(2)/day , adriamycin 90 mg/m(2)/day , vincristine and prednisone alternating with three courses of etoposide , cisplatin , cytarabine and prednisone . Responders were su bmi tted to ASCT . RESULTS Sixty-eight percent of patients received the planned treatment . After chemotherapy , 20 patients reached complete response ( CR ) , 4 partial response and 17 failed . ASCT was carried out in 17 of 24 c and i date s due to lack of mobilization ( three cases ) , toxicity ( two ) , early relapse and patient decision ( one each ) . CR rate after treatment was 51 % . With a median follow-up of 3.2 years , 5 of 21 CR patients relapsed and 2 died in CR due to secondary neoplasms . Four-year progression-free survival was 30 % . Twenty-two patients have died , with a 4-year overall survival of 39 % . International Prognostic Index was the main variable predicting survival . No differences were seen among the 24 c and i date s according to whether or not they underwent ASCT . CONCLUSION This intensive regimen result ed in moderate CR rate , with manageable toxicity in PTCL . The contribution of ASCT in preventing relapse is debatable . Novel strategies to increase CR warrant investigation Peripheral T‐Cell lymphomas ( PTCL ) are relatively rare diseases but appear to be highly aggressive and display worse remission and survival rates than B‐cell lymphomas . Despite unsatisfactory results with the cyclophosphamide , doxorubicin , vincristine , prednisone ( CHOP ) regimen , it remains the reference front‐line therapy in these diseases , but has not been challenged in phase III trials . The Groupe Ouest Est d’Etude des Leucémies et Autres Maladies du Sang ( GOELAMS ) devised an alternative therapeutic schedule including etoposide , ifosfamide , cisplatin alternating with doxorubicin , bleomycin , vinblastine , dacarbazine ( VIP‐reinforced‐ABVD ; VIP‐rABVD ) and compared it to CHOP/21 as front‐line treatment in non‐cutaneous PTCL . All newly diagnosed patients were eligible . The primary objective was to improve the 2‐year event‐free survival ( EFS ) rate . Secondary objectives were to compare the response rate , overall survival , and toxicities as well as identify prognostic factors . Eighty‐eight patients were identified between 1996 and 2002 . Both arms were well balanced for patients ’ characteristics in terms of histological and clinical presentation . No significant difference was observed between the two arms in terms of 2‐year EFS . Anaplastic large cell lymphoma type and Ann Arbor stage I – II were identified as two independent favourable prognostic factors influencing survival . VIP‐rABVD was not superior to CHOP/21 in terms of EFS as first‐line treatment of PTCL , confirming that CHOP/21 remains the reference regimen in these lymphomas We report the results of two prospect i ve phase II studies investigating the role of high-dose sequential chemotherapy , followed by autologous stem cell transplantation ( ASCT ) in 62 patients with advanced stage peripheral T-cell lymphomas ( PTCLs ) at diagnosis . Conditioning regimen consisted of mitoxantrone ( 60 mg/m2 ) and melphalan ( 180 mg/m2 ) or carmustine , etoposide , Ara-C and melphalan followed by peripheral blood stem cell autografting . In an intent-to-treat analysis , 46 out of 62 patients ( 74 % ) completed the whole programme , whereas 16 patients did not undergo ASCT , mainly because of disease progression . At a median follow-up of 76 months , the estimated 12-year overall ( OS ) , disease-free and event-free survival ( EFS ) were 34 , 55 and 30 % , respectively . OS and EFS were significantly better in patients with anaplastic lymphoma-kinase (ALK)-positive anaplastic large-cell lymphoma ( ALCL ) , as compared with the remaining PTCL . Multivariate analysis showed that patients attaining complete remission ( CR ) before ASCT had a statistically significant benefit in terms of OS and EFS ( P<0.0001 ) . Overall treatment-related mortality rate was 4.8 % . In conclusion , our findings indicate ( 1 ) up-front high-dose therapy and ASCT are feasible , but could induce a high rate of long-term CR only in patients with ALK-positive ALCL and ( 2 ) the achievement of CR before autografting is a strong predictor of better survival OBJECTIVE Retrospective data shows that peripheral T-cell lymphoma ( PTCL ) patients sensitive to conventional chemotherapy for aggressive lymphomas may respond better if this treatment is consoli date d with frontline autologous stem cell transplantation ( ASCT ) . Here , we present data from a prospect i ve phase II trial of high-dose chemotherapy and ASCT as a frontline consolidation therapy for aggressive nodal PTCL . METHODS This study involved 26 gallium-scan-positive patients with high-risk nodal PTCL [ excluding anaplastic lymphoma kinase ( ALK ) positive ] . Patients received three courses of MegaCHOP before they were evaluated , and those that were gallium-scan-negative at this stage then received another course of MegaCHOP and ASCT . Patients who remained gallium-scan-positive received two courses of an IFE regimen ( ifosfamide 10 g/m(2 ) , etoposide 150 mg/m(2)/12 h on days 1 - 3 ) and if they at least achieved PR , they then received the transplant . RESULTS Complete response ( CR ) was achieved by 12 patients ( 46 % ) after three courses of MegaCHOP and 12 patients received IFE as a salvage therapy . After the ASCT ( n = 19 ) , 89 % of patients achieved CR . In contrast , six patients ( 23 % ) did not receive the transplant because of the progression of the disease ( n = 5 ) or lethal toxicity ( n = 1 ) . One patient in first-line CR refused ASCT . After a median follow-up of 35 months , the overall survival ( OS ) and progression-free survival ( PFS ) at 3 yr was 73 % and 53 % , respectively . Moreover , the OS , PFS and disease-free survival ( DFS ) were 84 % , 56 % and 63 % , respectively 2 yr after transplant in patients who received ASCT consolidation ( n = 19 ) . CONCLUSIONS Early salvage therapy for patients with high-risk aggressive nodal PTCL that do not achieve CR after three courses of chemotherapy and ASCT frontline consolidation for chemosensitive patients may improve treatment outcome To evaluate outcome and prognosis of patients with T-cell lymphoma we analyzed 343 patients treated within trials of the German High- Grade Non-Hodgkin Lymphoma Study Group ( DSHNHL ) . Two hundred eighty-nine patients belonged to 1 of the 4 major T-cell lymphoma subtypes : anaplastic large cell lymphoma ( ALCL ) , anaplastic large cell lymphoma kinase (ALK)-positive ( n = 78 ) ; ALCL , ALK-negative ( n = 113 ) ; peripheral T-cell lymphoma , unspecified ( PTCLU ; n = 70 ) ; and angioimmunoblastic T-cell lymphoma ( AITL ; n = 28 ) . Treatment consisted of 6 - 8 courses of CHOP ( cyclophosphamide , doxorubicin , vincristine , prednisone/prednisolone ) or etoposide plus ( CHOEP ) . Three-year event-free survival ( EFS ) and overall survival were 75.8 % and 89.8 % ( ALK-positive ALCL ) , 50.0 % and 67.5 % ( AITL ) , 45.7 % and 62.1 % ( ALK-negative ALCL ) , and 41.1 % and 53.9 % ( PTCLU ) , respectively . The International Prognostic Index ( IPI ) was effective in defining risk groups with significantly different outcomes . For patients , ≤ 60 years with lactate dehydrogenase ≤ upper normal value ( UNV )  , etoposide improved improved 3-year EFS : 75.4 % versus 51.0 % , P = .003 . In patients > 60 years 6 courses of CHOP administered every 3 weeks remains the st and ard therapy . Patients with ALK-negative ALCL , PTCLU , or AITL presenting with IPI > 1 have a poor prognosis and should be considered c and i date s for novel treatment strategies PURPOSE Systemic peripheral T-cell lymphomas ( PTCLs ) respond poorly to conventional therapy . To evaluate the efficacy of a dose-dense approach consoli date d by up-front high-dose chemotherapy ( HDT ) and autologous stem-cell transplantation ( ASCT ) in PTCL , the Nordic Lymphoma Group ( NLG ) conducted a large prospect i ve phase II study in untreated systemic PTCL . This is the final report , with a 5-year median follow-up , of the NLG-T-01 study . PATIENTS AND METHODS Treatment-naive patients with PTCL age 18 to 67 years ( median , 57 years ) were included . Anaplastic lymphoma kinase ( ALK ) -positive anaplastic large-cell lymphoma ( ALCL ) was excluded . An induction regimen of six cycles of biweekly CHOEP ( cyclophosphamide , doxorubicin , vincristine , etoposide , and prednisone ) was administered ( in patients age > 60 years , etoposide was omitted ) . If in complete or partial remission , patients proceeded to consolidation with HDT/ASCT . RESULTS Of 166 enrolled patients , 160 had histopathologically confirmed PTCL . The majority presented with advanced-stage disease , B symptoms , and elevated serum lactate dehydrogenase .  A total of 115 underwent HDT/ASCT , with 90 in complete remission at 3 months post-transplantation . Early failures occurred in 26 % . Treatment-related mortality was 4 % . At 60.5 months of median follow-up , 83 patients were alive . Consoli date d 5-year overall and progression-free survival ( PFS ) were 51 % ( 95 % CI , 43 % to 59 % ) and 44 % ( 95 % CI , 36 % to 52 % ) , respectively . Best results were obtained in ALK-negative ALCL . CONCLUSION Dose-dense induction followed by HDT/ASCT was well tolerated and led to long-term PFS in 44 % of treatment-naive patients with PTCL . This represents an encouraging outcome , particularly considering the high median age and adverse risk profile of the study population . Therefore , dose-dense induction and HDT/ASCT are a rational up-front strategy in transplantation-eligible patients with PTCL 
    Output:
    
There are no data available on the role of HDC-ASCT for PTCL from r and omized controlled trials .
The achievement of first CR ( CR1 ) before ASCT appears to be a strong predictor of improved survival .
However , this observation reflects selection bias : patients who achieve CR1 have inherently more chemo-sensitive disease and are more likely to proceed to HDCASCT .