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Allogeneic transplantation in T-cell lymphomas.

Norbert Schmitz¹, Huei-Shan Wu¹, Bertram Glass¹

¹Department of Hematology, Oncology and Stem Cell Transplantation, Asklepios Hospital St. Georg, Hamburg, Germany.

Seminars in Hematology

|January 29, 2014

Summary

Allogeneic stem cell transplant (alloSCT) offers promising survival for relapsed/refractory T-cell lymphomas. Further research is needed to optimize alloSCT protocols for these aggressive lymphomas.

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Area of Science:

Hematology
Oncology
Immunology

Background:

Mature T- and natural killer (NK) cell lymphomas, excluding ALK-positive ALCL and limited disease, generally have a poor prognosis.
Existing treatments offer limited long-term survival for relapsed or refractory T-cell lymphomas.

Purpose of the Study:

To evaluate the efficacy of allogeneic transplantation of hematopoietic stem cells (alloSCT) in patients with relapsed or refractory T-cell lymphomas.
To assess the potential of alloSCT for less frequent T- and NK-cell lymphoma subtypes.

Main Methods:

Review of outcomes for patients with relapsed/refractory T-cell lymphomas undergoing alloSCT.
Analysis of survival rates in patients with various T- and NK-cell lymphoma subtypes post-alloSCT.

Main Results:

Long-term survival rates of 35%-50% were observed in patients with relapsed/refractory ALK-negative ALCL, AITL, or PTCL-NOS after alloSCT.
Promising survival outcomes were noted in less common subtypes, including NK/T-cell lymphoma and cutaneous T-cell lymphomas.
alloSCT results surpassed those of other treatment modalities, including novel agents.

Conclusions:

alloSCT should be considered for patients with relapsed/refractory T-cell lymphomas.
Optimal alloSCT conditioning regimens and transplant procedures require further investigation due to limited patient numbers and lack of comparative studies.
Current data are insufficient to recommend alloSCT outside of clinical trials for first-line therapy in poor-risk T-cell lymphomas.