Allogeneic Blood or Marrow Transplantation with Post-transplantation Cyclophosphamide for Peripheral T-cell Lymphoma: Importance of Graft Source

Abstract

While allogeneic blood or marrow transplantation (alloBMT) is an effective therapy for peripheral T-cell lymphoma (PTCL), the optimal approach in this patient population remains to be determined. Here we review outcomes in 65 consecutive patients with PTCL who underwent alloBMT with non-myeloablative (NMA) conditioning and post-transplantation cyclophosphamide (PTCy) for graft-versus-host disease (GVHD) prophylaxis. The graft source was bone marrow (BM) in 46 patients (71%) and peripheral blood (PB) in 19 patients (29%); all patients in the BM cohort received 200 cGy TBI, and most in the PB cohort (15/19) received 400 cGy TBI. With a median follow up of 2.8 years (range, 290 days-14.2 years), the 2-year PFS for the entire cohort was 49% (95% confidence interval [CI] 38–64%), and the 2-year OS was 55% (95% CI 44–69%). Outcomes were significantly improved in those receiving PB, including 2-year PFS of 79% (95% CI 63–100%) vs. 39% (95% CI 27–56%), 2-year OS of 84% (95% CI 69–100%) vs. 46% (95% CI 33–63%), and 1-year cumulative incidence of (CuI) relapse of 5% (95% CI 0–16%) vs. 33% (95% CI 19–46%), with no difference in GVHD or non-relapse mortality (NRM).