Autologous stem cell transplantation in major T-cell lymphoma entities: An analysis by the EBMT Lymphoma Working Party.

Autologous stem cell transplantation (auto-SCT) is an established treatment for peripheral T-cell lymphoma (PTCL) to consolidate first remission and for patients with relapsed/refractory (r/r) disease. We aimed to examine the outcomes of patients with PTCL NOS, AITL, and ALK-negative ALCL undergoing auto-SCT between 2010 and 2022 and reported to EBMT. Adult patients with major T-cell entities who had received auto-SCT either up-front or for r/r disease were included. 2082 patients underwent up-front and 1249 salvage auto-SCT. Three-year progression-free (PFS) and overall survival (OS) after up-front auto-SCT were 55.2% and 73.1%. For r/r patients, 3-year PFS and OS were 42.6% and 59.5%. In multivariate analysis, male patients, histology other than ALK-negative ALCL, non-CR, and higher age at auto-SCT showed significantly lower PFS and OS after both, up-front and salvage auto-SCT, mostly reflecting the higher relapse incidence for these patients. Major outcomes did not significantly change when the analyses were restricted to the patients with PET-based response at auto-SCT (n = 2062). Auto-SCT demonstrated excellent outcomes when used up-front and surprisingly good results in salvage settings. Patients with ALK-negative ALCL survived significantly better than patients with PTCL NOS or AITL. Male gender, higher age, and non-CR at auto-SCT were associated with poor outcomes. Overall, auto-SCT is a valid treatment option in T-cell lymphoma where targeted therapies still play a limited role.