Allogeneic hematopoietic stem cell transplantation (halo-HCCT) may be a curative option for some patients with recurrent / refractory T-cell lymphoma (TCL), according to a retrospective study presented at the Virtual 62nd Annual American Society ) Meeting and exhibition.
Results from previous registry studies suggest that only about one-third of patients with relapsed TCL are free of disease 3 years after halo-HSCT, including a previous study by the same group of researchers that found 2-year PFS and OS at 48.9% and 61.7%, respectively.
The group conducted an ongoing study “to better understand the dynamics of allogeneic T-cell lymphoma transplantation with longer follow-up,” said Neha Mehta-Shah, Ph.D., of the University of Washington, DC, St. Louis, Missouri School of Medicine, and a study presenter. he said.
The retrospective study included 508 consecutive TCL patients who underwent allo-HSCT between 2000 and 2019 across 12 academic institutions. The mean age of patients in the group was 51 years, and at the time of transplantation, 54.4% were in complete remission (CR), 37.2% were in partial remission (PR), 5% had stable disease, and 3.2% had progressive disease There were 15.5% of patients who had undergone previous autologous transplantation. The conditioning regimens used before transplantation were myeloablative in 35.4%, reduced intensity / neemoeoablative in 63.6% and unknown in less than 1% of patients.
After alo-HSCT, the 2 and 5-year progression-free survival (PFS) rates were 45.8% and 39.4%, respectively.
The mean time from relapse to death after halo-HCCT was 10.2 months. Overall survival of 2 and 5 years (OS) was 59.1% and 50.8%, respectively. Of the 261 deaths recorded, 31% were transplant-related, 26.4% were due to progressive disease, and 42.5% were non-relapsed and / or unknown.
PFS was similar in patients with angioimmunoblastic, not otherwise designated, and ALK-positive or -negative anaplastic subtypes of large cells. Although PFS results were worse for patients with cutaneous TCL (P. = .0008), the OS scores were not significantly different from other TCL subtypes (44% for cutaneous TCL versus 53.1% for others; P. = .4573).
CR at the time of transplantation was associated with longer mean PFS and OS, with progressive disease associated with shorter PFS and OS.
Dr. Mehta-Shah concluded that “in the largest series of allogeneic transplants to date, allogeneic transplants for TCL patients can lead to permanent remissions in patients with otherwise poor results.”
Disclosure of information: Some of the presenters disclosed their financial relationships with the pharmaceutical and / or medical device industries. For a full list of disclosures, see the abstract of the presentation.
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Mehta-Shah N, Komalapat A, Teja S, and others. 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.