A large single-center experience with allogeneic stem-cell transplantation for peripheral T-cell non-Hodgkin lymphoma and advanced mycosis fungoides/Sezary syndrome

Jacobsen, Eric; Kim, H. T.; Ho, Vincent T.; Cutler, Corey; Koreth, John; Fisher, David C.; Armand, Philippe; Alyea, Edwin P.; Freedman, Arnold S.; Soiffer, RJ; Antin, Joseph H.

doi:10.1093/annonc/mdq698

Cited by 96 publications

(75 citation statements)

References 12 publications

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“…18 Of note, a single-center review of 52 patients found that RIC regimens conferred a seven-fold increased risk of relapse but no difference in either PFS or OS. 19 Our series found no difference in 3-year transplantation-related mortality, PFS, OS, or risk of relapse/progression by alloHCT regimen intensity. In addition, neither AGVHD nor CGVHD correlated with outcome, although patients not in remission at time of transplantation had a four-fold increased risk of CGVHD.…”

Section: Wwwjcoorgcontrasting

confidence: 44%

Hematopoietic Cell Transplantation for Systemic Mature T-Cell Non-Hodgkin Lymphoma

Smith

Burns

Besien

et al. 2013

JCO

211

161

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A B S T R A C T PurposeTo analyze outcomes of hematopoietic cell transplantation (HCT) in T-cell non-Hodgkin lymphoma. Patients and MethodsOutcomes of 241 patients (112 anaplastic large-cell lymphoma, 102 peripheral T-cell lymphoma not otherwise specified, 27 angioimmunoblastic T-cell lymphoma) undergoing autologous HCT (autoHCT; n ϭ 115; median age, 43 years) or allogeneic HCT (alloHCT; n ϭ 126; median age, 38 years) were analyzed. Primary outcomes were nonrelapse mortality (NRM), relapse/progression, progression-free survival (PFS), and overall survival (OS). Patient, disease, and HCT-related variables were analyzed in multivariate Cox proportional hazard models to determine association with outcomes. ResultsAutoHCT recipients were more likely in first complete remission (CR1; 35% v 14%; P ϭ .001) and with chemotherapy-sensitive disease (86% v 60%; P Ͻ .001), anaplastic large-cell histology (53% v 40%; P ϭ .04), and two or fewer lines of prior therapy (65% v 44%; P Ͻ .001) compared with alloHCT recipients. Three-year PFS and OS of autoHCT recipients beyond CR1 were 42% and 53%, respectively. Among alloHCT recipients who received transplantations beyond CR1, 31% remained progression-free at 3 years, despite being more heavily pretreated and with more refractory disease. NRM was 3.5-fold higher (95% CI, 1.80 to 6.99; P Ͻ .001) for alloHCT. In multivariate analysis, chemotherapy sensitivity (hazard ratio [HR], 1.8; 95% CI, 1.16 to 2.87) and two or fewer lines of pretransplantation therapy (HR, 5.02; 95% CI, 2.15 to 11.72) were prognostic of survival. ConclusionThese data describe the roles of autoHCT and alloHCT in T-cell non-Hodgkin lymphoma and suggest greater effectiveness earlier in the disease course, and limited utility in multiply relapsed disease. Notably, autoHCT at relapse may be a potential option for select patients, particularly those with anaplastic large-cell lymphoma histology.

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Section: Wwwjcoorgcontrasting

confidence: 44%

Hematopoietic Cell Transplantation for Systemic Mature T-Cell Non-Hodgkin Lymphoma

Smith

Burns

Besien

et al. 2013

JCO

211

161

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“…The stratification for transplant type revealed the best survival data (OS 80 % at 10 years) for familiar alloSCT compared to both other transplant modalities. These results are in line with reports from other investigators [5,9,23]. Corradini et al [6] reported a 5 year overall survival of 80 % after RIC and alloSCT from mainly related donors.…”

Section: Discussionsupporting

confidence: 90%

Treatment of High-Risk T-NHL with Stem Cell Transplantation: A Single Center Experience

Busemann

Klein

Schmidt

et al. 2014

Indian J Hematol Blood Transfus

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Prognosis of peripheral and other advanced T cell lymphomas is poor. 20 patients with a median age of 46.4 (range 20.5-64.1) years were treated with autoSCT (n = 6) or alloSCT (n = 14) from 1996 to 2013. All patients were at high risk either due to the IPI-score or to the fact that SCT was part of a salvage therapy. Conditioning prior to alloSCT was myeloablative in seven cases (50 %). The patients were pretreated with 8.5 (median, range 2-38) cycles of chemotherapy. Ten patients are alive in CR after a median follow-up of 1.3 years (range 0.1-13.3). OS was 53 % after one and 40 % after 10 years. Best survival was reached after related alloSCT (80 % at 10 years) compared to other modalities. GvHD did not influence survival. AlloSCT from related donors can cure patients from T-cell lymphomas. Unrelated alloSCT or high-dose therapy and autoSCT are an option for patients without a familiar donor.

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“…5 A response to DLI has also been reported in a small number of patients with non cutaneous TCL. [4][5][6]8 Itonaga et al 13 recently reported results for 35 patients who relapsed after allo-SCT for adult T-cell leukemia/lymphoma. Immunosuppressive drugs were tapered in 29 patients, resulting in two CRs.…”

Section: Discussionmentioning

confidence: 99%

“…2 Allogenic SCT (allo-SCT) is increasingly used as an alternative strategy, based on a potent graft-versus-lymphoma effect (GvL). However, data from retrospective [3][4][5][6][7][8][9][10][11] and prospective non-randomized studies 12 are insufficient to recommend allo-SCT as first-line treatment. The European Bone Marrow Transplantation Society currently considers allo-SCT to be an option for selected patients with chemosensitive disease in first or second complete response (CR), if a sibling or unrelated HLA-matched donor is available (grade 2 recommendations).…”

Section: Introductionmentioning

confidence: 99%

“…5 Some responses have been reported after immunomodulation based on tapering of immunosuppressive drugs and/or on donor lymphocyte infusion (DLI). [4][5][6][7][8]13,14 To better assess the possible GvL effect in PTCL, we studied 63 patients who relapsed after allo-SCT, focusing on the impact of immunomodulation based on tapering of immunosuppressive drugs and/or DLI on subsequent outcome.…”

Section: Introductionmentioning

confidence: 99%

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Effect of immune modulation in relapsed peripheral T-cell lymphomas after post-allogeneic stem cell transplantation: a study by the Société Française de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC)

Mamez

Lévy

Chevallier

et al. 2015

Bone Marrow Transplant

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Peripheral T-cell lymphoma carries a poor prognosis. To document a possible graft-versus-lymphoma effect in this setting, we evaluated the impact of immunomodulation in 63 patients with peripheral T-cell lymphoma who relapsed after allogeneic transplant in 27 SFGM-TC centers. Relapse occurred after a median of 2.8 months. Patients were then treated with nonimmunologic strategies (chemotherapy, radiotherapy) and/or immune modulation (donor lymphocyte infusions (DLI) and/or discontinuation of immunosuppressive therapy). Median overall survival (OS) after relapse was 6.1 months (DLI group: 23.6 months, non-DLI group: 3.6 months). Among the 14 patients who received DLI, 9 responded and 2 had stable disease. Among the remaining 49 patients, a complete response accompanied by extensive chronic GvHD was achieved in two patients after tapering of immunosuppressive drugs. Thirty patients received radio-chemotherapy, with an overall response rate of 50%. In multivariate analysis, chronic GvHD (odds ratio: 11.25 (2.68-48.21), P = 0.0009) and skin relapse (odds ratio: 4.15 (1.04-16.50), P = 0.043) were associated with a better response to treatment at relapse. In a time-dependent analysis, the only factor predictive of OS was the time from transplantation to relapse (hazards ratio: 0.33 (0.17-0.640), P = 0.0009). This large series provides encouraging evidence of a true GvL effect in this disease.

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A large single-center experience with allogeneic stem-cell transplantation for peripheral T-cell non-Hodgkin lymphoma and advanced mycosis fungoides/Sezary syndrome

Cited by 96 publications

References 12 publications

Hematopoietic Cell Transplantation for Systemic Mature T-Cell Non-Hodgkin Lymphoma

Hematopoietic Cell Transplantation for Systemic Mature T-Cell Non-Hodgkin Lymphoma

Treatment of High-Risk T-NHL with Stem Cell Transplantation: A Single Center Experience

Effect of immune modulation in relapsed peripheral T-cell lymphomas after post-allogeneic stem cell transplantation: a study by the Société Française de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC)

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