2022 What is the status of EBMT hematopoietic stem cell transplantation in the treatment of peripheral T-cell lymphoma?

Peripheral T-cell lymphomas (PTCLs) are a rare group of aggressive non-Hodgkin lymphomas that arise from mature T lymphocytes and in most cases are characterized by a refractory or relapsed course after standard therapy
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We performed a retrospective multicenter analysis of the treatment of PTCL, focusing on hematopoietic stem cell transplantation (HSCT)
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The study was selected for the poster presentation of the 48th European Society of Blood and Marrow Transplantation (EBMT) annual meeting in 2022.
The editor will organize the main contents as follows for the reference of readers
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Methods A total of 151 patients with PTCL diagnosed between 2005 and 2021 at 5 centers in Russia and Kazakhstan were included in the study
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The most common histological types were peripheral T-cell lymphoma unspecified (PTCL-NOS; n=51); ALK+ anaplastic large cell lymphoma (ALCL) (n=21); ALK-ALCL (n=26); Angioimmunoblastic T-cell lymphoma (AITL; n=24), and the remaining patients (n=29) were the rarer type of PTCL
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The median age of the patients was 46 years (range: 1-76 years)
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Ninety-four (62%) patients had primary refractory disease, and 32 (21%) patients relapsed after first-line therapy
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A total of 39 patients received autologous hematopoietic stem cell transplantation (ASCT) as consolidation therapy, 10 after first remission, 20 after second-line therapy, and 8 after third-line therapy
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On ASCT, all patients were in complete remission (CR) or partial remission (PR)
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Nineteen patients with a more aggressive PTCL course underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) at first transplant (n=14) or after ASCT failure (n=5)
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Results With a median follow-up of 35 months (range: 1-277 months), 77 patients were alive at the time of analysis
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The median overall survival (OS) was not reached, and the 3-year OS rate was 54%
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The median progression-free survival (PFS) was 4 months, and the 3-year PFS rate was 16%
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Compared with patients who received ASCT (3-year OS rate: 55%) or allo-HSCT (3-year OS rate: 71%), patients who did not receive HSCT had a worse prognosis (3-year OS rate: 45%)
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After ASCT and allo-HSCT, the 3-year PFS rates were 24% and 55%, respectively
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First-line ASCT provides patients with a better prognosis than ASCT used for second-line and subsequent treatment
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Patients who achieved PR or CR on allo-HSCT had a better prognosis than patients with stable or progressive disease on allo-HSCT (3-year OS rate: 84% vs 25%)
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Study Conclusions The data from this study demonstrate that allo-HSCT and ASCT are effective treatments for patients with PTCL
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If remission is achieved, first-line ASCT is the clinical choice of choice for most types of PTCL
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In the setting of a refractory or relapsed course of PTCL, achieving allo-HSCT at the time of CR or PR status is associated with a better prognosis
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Reference: E.
Lepik, V.
Kovalik, A.
Kozlov, et al.
PLACE OF HEMATOPOIETIC STEM CELL TRANSPLANTATION IN THE TREATMENT OF PERIPHERAL T-CELL LYMPHOMAS: A MULTICENTER EXPERIENCE.
The 48th Annual Meeting of the EBMT.
Abstract P603.
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