Allogeneic hematopoietic SCT for primary cutaneous T cell lymphomas

Abstract

Cutaneous T-cell lymphomas (CTCL) are a heterogeneous group of non-Hodgkin lymphomas that are considered incurable. The role of allogeneic hematopoietic stem cell transplantation (HSCT) in the treatment of CTCL is not well defined but may provide potent graft-vs-lymphoma (GVL) activity independent of the conditioning therapy. We present outcomes of 12 extensively-pretreated patients with CTCL who underwent allogeneic HSCT using, most commonly, a reduced intensity conditioning (RIC) regimen. Median age at diagnosis of CTCL was 49 yrs, and median time to transplantation from diagnosis was 3.3 years. Transplant induced and maintained CR in 6 patients with active disease supporting the presence of a GVL effect. Transplant related mortality was low, and 42% of patients were alive and disease-free a median duration of 22 months after transplant. Two patients showed strong and direct evidence of a GVL effect with a direct response to withdrawal of immunosuppression or to donor leukocyte infusion (DLI). Our data show that HSCT can provide long-term disease control in patients with advanced CTCL otherwise refractory to immunotherapy and chemotherapy.

Allogeneic stem cell transplantation for advanced cutaneous T-cell lymphomas: a study from the French Society of Bone Marrow Transplantation and French Study Group on Cutaneous Lymphomas

“…However, owing to the extreme scarcity of these diseases, there are very few data regarding allogeneic HSCT in transformed mycosis fungoides. [8][9][10]13,14 We are unaware of published data regarding allogeneic HSCT in advanced primary cutaneous anaplastic large-cell lymphomas, as this disease rarely leads to visceral involvement. 7 Moreover, we found similar outcomes after allogeneic HSCT regardless of the subtype of primary cutaneous T-cell lymphoma, suggesting that our cohort was quite uniform in terms of prognosis.…”

“…Primary cutaneous CD30-positive anaplastic large cell lymphoma is a less frequent subtype of primary cutaneous T-cell lymphoma that, in its disseminated form, shares an aggressive clinical course. 7 Allogeneic HSCT has been reported in advanced mycosis fungoides and Sézary syndrome in retrospective cases or case series, [8][9][10][11][12][13] the 2 largest including 19 10 and 60 11 patients. Allogeneic HSCT for transformed mycosis fungoides has only been reported in case reports (n=11).…”

“…Allogeneic HSCT for transformed mycosis fungoides has only been reported in case reports (n=11). [8][9][10]13,14 Even less is known regarding allogeneic HSCT in other less frequent subtypes of advanced primary cutaneous T-cell lymphomas (γδ cutaneous T-cell lymphoma, n=3; 13,15 subcutaneous panniculitic T-cell lymphoma, n=2; 16,17 CD30-negative primary cutaneous T-cell lymphoma, n=1;…”

Hematopoietic Stem Cell Transplant for Mycosis Fungoides and Sézary Syndrome

“…Several case reports and series have been published since then as indicated in Table 1. 18,[36][37][38][39][40][41][42][43][44][45][46] However, the experience of allogeneic transplant for treatment of MF/SS is limited to small retrospective studies with small number of patients usually lumped together with transplant data for subtypes of T cell and other NHL. The following discussion attempts to tease out data specific to CTCL and its subtypes.…”

Mycosis fongoïde érythrodermique et syndrome de Sézary

“…Ce traitement repose sur l'eff et antitumoral induit par la greff e [36]. Une récente étude chez 12 patients atteints de lymphomes T cutanés résistant à de multiples traitements a montré que 42 % des patients étaient en vie sans récidive après 22 mois de suivi [37].…”