Haploidentical stem cell transplantation for patients with lymphoma: a position statement from the Lymphoma Working Party-European Society for Blood and Marrow Transplantation

Abstract

Allogeneic stem cell transplantation (alloSCT) continues to be the only potentially curative treatment for patients with refractory lymphomas or relapsing after autologous stem cell transplantation. Until recently, alloSCT was restricted to patients who had a matched donor, sibling or unrelated. In the past years, substantial progress in haploidentical transplantation (haploSCT) has resulted in a significant increase in the number of patients treated with this procedure, worldwide. Given the fact that an HLA haplo-identical donor can be found within the immediate family for almost any patient, virtually every patient can receive an haploSCT. Another reason to use haploSCT, especially in diseases like lymphomas where the decision to perform an alloSCT is being taken sometimes late in the course of the disease, is the considerable delay to find a matched unrelated donor (MUD), when an HLA-identical sibling (MSD) is not available. In this paper, we summarize available evidence supporting the use of haploSCT in lymphoma patients and share current recommendations of the Lymphoma Working Party of the European Society for Blood and Marrow Transplantation (EBMT) on how to integrate haploSCT in this population.

Allogeneic hematopoietic stem cell transplantation for advanced mycosis fungoides and Sézary syndrome. An updated experience of the Lymphoma Working Party of the European Society for Blood and Marrow Transplantation

“…In spite of the higher experience in the use of URD allo-HSCT in these histologies, URD came out as an adverse prognostic factor for OS in this extended report; in light of these results, one may argue that haploidentical transplants using the postcyclophosphamide platform as GVHD prophylaxis could eventually be a better option for those patients that do not have a matched sibling donor available. The use of haploidentical donors has significantly increased over the last few years and, in the absence of well-designed prospective clinical trials, long term outcomes are not different from those of URD and matched sibling transplants [24]. Investigators of the MD Anderson Cancer Center [16] indicated in their prospective single center analysis of allo-HSCT in both MF and SS patients, that SS patients had a better long term outcome than MF patients.…”

Refractory Primary Mediastinal B-Cell Lymphoma: A Case Report of Conventional Chemotherapies, Immune Checkpoint Inhibitors, Polatuzumab Vedotin, Transplantation, and Post-Transplant Large Granular Lymphocytosis

“…Allogeneic HCT is an accepted consolidation strategy in salvage therapy of refractory or relapsed aggressive B-cell lymphomas and haploidentical HCT has demonstrated efficacy in such situations. 14 15 As she had no matched donors in her family or accessed donor registries, consolidation was achieved using a RIC haploidentical allogeneic HCT, which was largely uneventful. She developed T-LGL around day 165 post-HCT, which manifested as persistent cytopenia and lymphocytosis.…”

Resolution of bone, cutaneous, and muscular involvement after haploidentical hematopoietic stem cell transplantation followed by post‐transplant cyclophosphamide in adult T‐cell leukemia/lymphoma

“…However, since the availability of HLA‐matched sibling donors has decreased due to the aging of both patients and siblings, 3 haplo‐identical donors within the immediate family have emerged as alternative stem cell sources 11 . Allo‐HSCT from haploidentical donors (Haplo‐HSCT) has been revolutionized by the use of PT‐CY, targeting alloreactive T cells, thereby preventing acute GVHD 3,12,13 …”