Background <p>Allogeneic hematopoietic stem cell transplantation (allo-SCT) is an established treatment for peripheral T-cell lymphoma (PTCL), particularly for patients with relapsed/refractory (r/r) disease. We aimed to retrieve novel information on the role of histology, disease status prior to transplantation, and donor choice for patients with PTCL not otherwise specified (NOS), angioimmunoblastic T-cell lymphoma (AITL), and anaplastic lymphoma kinase (ALK)-negative ALCL. We compared imaging by computed tomography (CT) or positron emission tomography (PET) for defining disease status prior to allo-SCT.</p> Methods <p>Eligible were adult patients with PTCL-NOS, AITL, and ALK-negative ALCL undergoing allo-SCT between 2010 and 2022 and reported to EBMT. </p> Results <p>1958 patients underwent allo-SCT. Of patients with known number of prior lines of therapies (n = 1310), 301 (23%), 431 (32.9%) and 578 (44.1%) patients received allo-SCT after one (1L), two (2L) or three or more therapy lines (3L +), respective. Three-year GvHD-free, relapse-free survival (GRFS), progression-free survival (PFS) and overall survival (OS) were 35.8%, 50.9% and 56.8%, respectively. Three-year relapse incidence (RI) and non-relapse mortality were 25.1% and 24.1%, respectively. In multivariate analysis, histology other than AITL, no complete response (CR) at transplantation, having a haploidentical donor and higher age at allo-SCT resulted in significantly lower PFS and/or OS. Prior autologous SCT had no impact on the results of allo-SCT and major outcomes did not significantly change when the analyses were restricted to the patients with PET-based response at allo-SCT. Patients allografted in partial response (PR) or SD/PD still achieved long-term survival with a 3-year PFS/OS of 46%/53.7% and 39.6%/43.6%, respectively.</p> Conclusion <p>Allo-SCT is a valid treatment option in relapsed/refractory PTCL where targeted therapies still play a limited role. Patients with AITL survived significantly better than patients with PTCL NOS or ALK-negative ALCL following a significantly lower RI, also when comparing CR/complete metabolic response (CMR) and PR patients separately. Higher age and non-CR at allo-SCT are associated with worse outcomes. </p>

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Allogeneic stem cell transplantation for major T-cell lymphoma entities: an analysis of the EBMT-lymphoma working party

  • Evgenii Shumilov,
  • Maud Ngoya,
  • Philipp Berning,
  • Raynier Devillier,
  • Edouard Forcade,
  • Thomas Schroeder,
  • Frank Kroschinsky,
  • Matthias Stelljes,
  • Veronika Valkova,
  • Francesca Kinsella,
  • Patrice Chevallier,
  • Gitte Olesen,
  • Mohamad Mohty,
  • Flore Sicre de Fontbrune,
  • Eva Wagner-Drouet,
  • Robert Zeiser,
  • Marco Herling,
  • Georg-Nikolaus Franke,
  • Lucía López-Corral,
  • Francis Ayuk,
  • Georg Lenz,
  • Gerald Wulf,
  • Anna Sureda,
  • Arain Laurence,
  • Peter Dreger,
  • Ali Bazarbachi,
  • Norbert Schmitz

摘要

Background

Allogeneic hematopoietic stem cell transplantation (allo-SCT) is an established treatment for peripheral T-cell lymphoma (PTCL), particularly for patients with relapsed/refractory (r/r) disease. We aimed to retrieve novel information on the role of histology, disease status prior to transplantation, and donor choice for patients with PTCL not otherwise specified (NOS), angioimmunoblastic T-cell lymphoma (AITL), and anaplastic lymphoma kinase (ALK)-negative ALCL. We compared imaging by computed tomography (CT) or positron emission tomography (PET) for defining disease status prior to allo-SCT.

Methods

Eligible were adult patients with PTCL-NOS, AITL, and ALK-negative ALCL undergoing allo-SCT between 2010 and 2022 and reported to EBMT.

Results

1958 patients underwent allo-SCT. Of patients with known number of prior lines of therapies (n = 1310), 301 (23%), 431 (32.9%) and 578 (44.1%) patients received allo-SCT after one (1L), two (2L) or three or more therapy lines (3L +), respective. Three-year GvHD-free, relapse-free survival (GRFS), progression-free survival (PFS) and overall survival (OS) were 35.8%, 50.9% and 56.8%, respectively. Three-year relapse incidence (RI) and non-relapse mortality were 25.1% and 24.1%, respectively. In multivariate analysis, histology other than AITL, no complete response (CR) at transplantation, having a haploidentical donor and higher age at allo-SCT resulted in significantly lower PFS and/or OS. Prior autologous SCT had no impact on the results of allo-SCT and major outcomes did not significantly change when the analyses were restricted to the patients with PET-based response at allo-SCT. Patients allografted in partial response (PR) or SD/PD still achieved long-term survival with a 3-year PFS/OS of 46%/53.7% and 39.6%/43.6%, respectively.

Conclusion

Allo-SCT is a valid treatment option in relapsed/refractory PTCL where targeted therapies still play a limited role. Patients with AITL survived significantly better than patients with PTCL NOS or ALK-negative ALCL following a significantly lower RI, also when comparing CR/complete metabolic response (CMR) and PR patients separately. Higher age and non-CR at allo-SCT are associated with worse outcomes.