Allogeneic hematopoietic stem cell transplant (allo-HSCT) may be a curative option for some patients with relapsed / refractory T cell lymphoma (TCL), according to the results of a retrospective study presented in the 62nd Annual American Society of Hematology (ASH). Meeting and Demonstration.
Results from previous registry studies suggest that only about one-third of patients with relapsing TCL are disease-free 3 years after allo-HSCT, including a previous study by this same group of researchers, who found that PFS and ‘ r 2 year OS is 48.9% and 61.7%, respectively.
The group conducted the current study “to better understand the dynamics of allogeneic transplantation in T-cell lymphoma and with longer follow-up,” Neha Mehta-Shah, MD, of Washington University School of Medicine in St. Louis, Missouri, and the presenter of the study, .
The retrospective study included 508 consecutive patients with TCL who underwent allo-HSCT between 2000 and 2019 across 12 academic institutions. The median age of the patients in the cohort was 51, and at the time of transplantation, 54.4% were in complete remission (CR), 37.2% were in partial relief (PR), 5% had stable disease, and 3.2% had progressive disease. 15.5% of patients had had a previous autologous transplant. Conditioning regimens used before transplantation were myeloablative in 35.4%, reduced intensity / nonmyeloablative in 63.6%, and unknown in less than 1% of patients.
After allo-HSCT, the 2 and 5-year progression-free survival (PFS) were 45.8% and 39.4%, respectively.
The median relapse to death after allo-HSCT was a median of 10.2 months. The 2- and 5-year overall survival (OS) was 59.1% and 50.8%, respectively. Among the 261 deaths recorded, 31% were transplant-related, 26.4% were due to progressive disease, and 42.5% were related to relapse and / or unknown.
PFS was similar among patients with the angioimmunoblastic anaplastic large cell subtypes, otherwise not specified, and ALK-positive or -negative anaplastic large cell subtypes. Although PFS results are worse for patients with mass TCL (P. = .0008), OS results were not significantly different from other TCL subtypes (44% for mass TCL compared to 53.1% for others; P. = .4573).
CR at the time of transplantation was associated with longer median PFS and OS, with progressive disease associated with shorter PFS and OS.
Dr Mehta-Shah concluded that “in the largest series of allogeneic transplantation to date, allogeneic transplantation for patients with TCL can lead to durable remissions in patients with otherwise poor outcomes.”
Disclosures: Some of the presenters disclosed financial relationships with the pharmaceutical and / or medical device industry. For a full list of disclosures, please refer to the presentation summary.
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Mehta-Shah N, Kommalapati A, Teja S, et al. Successful treatment of mature T-cell lymphoma with allogeneic stem cell transplantation: the largest multicenter retrospective analysis. Presented at: 62nd Annual Meeting and Exhibition of the American Society of Hematology (ASH); virtual; December 5-9, 2020. Abstract 41.