Risk-adapted, treosulfan-based therapy with auto- and allo-SCT for relapsed/refractory aggressive NHL: a prospective...

Area of Science:

• Hematology
• Oncology
• Stem Cell Transplantation

Background:

• Relapsed/refractory aggressive non-Hodgkin's lymphoma (NHL) has a variable prognosis.
• A risk-adapted treatment strategy is crucial for optimizing outcomes.

Purpose of the Study:

• To evaluate a risk-adapted, treosulfan-based conditioning regimen for aggressive NHL.
• To assess the feasibility and efficacy of autologous and allogeneic stem cell transplantation (SCT).

Main Methods:

• Patients received two cycles of DHAP followed by high-dose treosulfan/etoposide/carboplatinum (TEC) with autologous stem cell rescue.
• Low-risk patients achieving complete remission (CR) after DHAP received no further treatment.
• High-risk patients or those achieving only partial remission (PR) after TEC underwent further treatment, including allogeneic transplantation for refractory/early relapse disease.

Main Results:

• Overall, 42% of patients achieved CR.
• Median overall survival (OS) was 21.4 months, with 32.6 months for those undergoing allogeneic transplantation.
• Oral mucositis was the main toxicity after TEC (grades 3/4 in 50%/13%).

Conclusions:

• Risk-adapted, treosulfan-based therapy incorporating auto- and allo-SCT is feasible in aggressive NHL.
• Allogeneic transplantation offers potential for long-term survival in this patient group.
• International Prognostic Index (IPI) effectively predicts OS.