Journal of hematology & oncology · 2026
Allogeneic stem cell transplantation for major T-cell lymphoma entities: an analysis of the EBMT-lymphoma working party.
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Shumilov Evgenii, Ngoya Maud, Berning Philipp, Devillier Raynier, Forcade Edouard, Schroeder Thomas, Kroschinsky Frank, Stelljes Matthias, Valkova Veronika, Kinsella Francesca, Chevallier Patrice, Olesen Gitte, Mohty Mohamad, de Fontbrune Flore Sicre, Wagner-Drouet Eva, Zeiser Robert, Herling Marco, Franke Georg-Nikolaus, López-Corral Lucía, Ayuk Francis, Lenz Georg, Wulf Gerald, Sureda Anna, Laurence Arain, Dreger Peter, Bazarbachi Ali, Schmitz Norbert
Аннотация
BACKGROUND: Allogeneic hematopoietic stem cell transplantation (allo-SCT) is an established treatment for peripheral T-cell lymphoma (PTCL), particularly for patients with relapsed/refractory (r/r) disease. We aimed to retrieve novel information on the role of histology, disease status prior to transplantation, and donor choice for patients with PTCL not otherwise specified (NOS), angioimmunoblastic T-cell lymphoma (AITL), and anaplastic lymphoma kinase (ALK)-negative ALCL. We compared imaging by computed tomography (CT) or positron emission tomography (PET) for defining disease status prior to allo-SCT.
METHODS: Eligible were adult patients with PTCL-NOS, AITL, and ALK-negative ALCL undergoing allo-SCT between 2010 and 2022 and reported to EBMT.
RESULTS: 1958 patients underwent allo-SCT. Of patients with known number of prior lines of therapies (n = 1310), 301 (23%), 431 (32.9%) and 578 (44.1%) patients received allo-SCT after one (1L), two (2L) or three or more therapy lines (3L +), respective. Three-year GvHD-free, relapse-free survival (GRFS), progression-free survival (PFS) and overall survival (OS) were 35.8%, 50.9% and 56.8%, respectively. Three-year relapse incidence (RI) and non-relapse mortality were 25.1% and 24.1%, respectively. In multivariate analysis, histology other than AITL, no complete response (CR) at transplantation, having a haploidentical donor and higher age at allo-SCT resulted in significantly lower PFS and/or OS. Prior autologous SCT had no impact on the results of allo-SCT and major outcomes did not significantly change when the analyses were restricted to the patients with PET-based response at allo-SCT. Patients allografted in partial response (PR) or SD/PD still achieved long-term survival with a 3-year PFS/OS of 46%/53.7% and 39.6%/43.6%, respectively.
CONCLUSION: Allo-SCT is a valid treatment option in relapsed/refractory PTCL where targeted therapies still play a limited role. Patients with AITL survived significantly better than patients with PTCL NOS or ALK-negative ALCL following a significantly lower RI, also when comparing CR/complete metabolic response (CMR) and PR patients separately. Higher age and non-CR at allo-SCT are associated with worse outcomes.
METHODS: Eligible were adult patients with PTCL-NOS, AITL, and ALK-negative ALCL undergoing allo-SCT between 2010 and 2022 and reported to EBMT.
RESULTS: 1958 patients underwent allo-SCT. Of patients with known number of prior lines of therapies (n = 1310), 301 (23%), 431 (32.9%) and 578 (44.1%) patients received allo-SCT after one (1L), two (2L) or three or more therapy lines (3L +), respective. Three-year GvHD-free, relapse-free survival (GRFS), progression-free survival (PFS) and overall survival (OS) were 35.8%, 50.9% and 56.8%, respectively. Three-year relapse incidence (RI) and non-relapse mortality were 25.1% and 24.1%, respectively. In multivariate analysis, histology other than AITL, no complete response (CR) at transplantation, having a haploidentical donor and higher age at allo-SCT resulted in significantly lower PFS and/or OS. Prior autologous SCT had no impact on the results of allo-SCT and major outcomes did not significantly change when the analyses were restricted to the patients with PET-based response at allo-SCT. Patients allografted in partial response (PR) or SD/PD still achieved long-term survival with a 3-year PFS/OS of 46%/53.7% and 39.6%/43.6%, respectively.
CONCLUSION: Allo-SCT is a valid treatment option in relapsed/refractory PTCL where targeted therapies still play a limited role. Patients with AITL survived significantly better than patients with PTCL NOS or ALK-negative ALCL following a significantly lower RI, also when comparing CR/complete metabolic response (CMR) and PR patients separately. Higher age and non-CR at allo-SCT are associated with worse outcomes.