Allogeneic haematopoietic SCT for natural killer/T-cell lymphoma: a multicentre analysis from the Asia Lymphoma Study Group

Abstract

Eighteen patients (men = 14; women = 4) with natural killer (NK)/T-cell lymphomas (CR1, N = 9; CR2, N = 7; PR, N = 1; progressive disease, N = 1) undergoing allogeneic haematopoietic SCT (HSCT) (myeloablative, N = 14; reduced intensity, N = 4) were analyzed. With a median follow-up of 20.5 months, the 5-year OS was 57% and 5-year EFS was 51%. The use of the SMILE regimen pre-HSCT was the most important positive prognostic indicator, resulting in significantly superior OS and EFS (P o 0.01). Acute GVHD had a significant negative impact on OS (P = 0.03). CR1 and CR2 patients had similar survivals, but all patients who were not transplanted in remission died. Chronic GVHD, International Prognostic Index, disease stage, primary sites of involvement, conditioning regimen and source of HSC did not affect survival. Although allogeneic HSCT leads to reasonable survival for NK/T-cell lymphoma patients, results need to be compared with those in patients receiving L-asparaginase-containing regimens. Novel prognostic models incorporating biomarkers, such as circulating EBV DNA, are needed to identify high-risk patients who may benefit from allogeneic HSCT.

High-dose methotrexate, etoposide, dexamethasone and pegaspargase (MEDA) combination chemotherapy is effective for advanced and relapsed/refractory extranodal natural killer/T cell lymphoma: a retrospective study

“…Successful treatment of advanced, refractory and relapsed ENK/TCL with allogeneic HSCT has been reported. Patients who were treated with l-asparaginase-containing regimens for remission induction had significantly better OS and event-free survival after allogeneic HSCT [32,33]. The available data on allogeneic HSCT for ENK/TCL patients are limited.…”

Diagnosis and management of extranodal NK/T cell lymphoma nasal type

“…80 Thirteen patients had advanced-stage disease at presentation. Myeloablative conditioning was used in 78%.…”

NCCN Guidelines Insights: T-Cell Lymphomas, Version 2.2018

“…45 Allogeneic HCT has also been evaluated in retrospective studies predominantly involving Asian patients. 42,46,47 The use of the SMILE regimen before HCT was the most important positive prognostic indicator for superior OS and event-free survival (P<.01) in patients with stage IV ENKL at first CR or chemotherapy-sensitive R/R disease. 47 In a more recent retrospective analysis from the Center for International Blood and Marrow Transplant Research that evaluated allogeneic HCT in a predominantly Caucasian patient cohort, 3-year PFS and OS rates were 28% and 34%, respectively.…”

“…42,46,47 The use of the SMILE regimen before HCT was the most important positive prognostic indicator for superior OS and event-free survival (P<.01) in patients with stage IV ENKL at first CR or chemotherapy-sensitive R/R disease. 47 In a more recent retrospective analysis from the Center for International Blood and Marrow Transplant Research that evaluated allogeneic HCT in a predominantly Caucasian patient cohort, 3-year PFS and OS rates were 28% and 34%, respectively. 48 Survival rates were similar regardless of the remission status before allogeneic HCT, suggesting that allogeneic HCT may be associated with a survival benefit even in the subset of patients with chemorefractory disease at time of transplant.…”