[Salvage allogeneic hematopoietic stem cell transplantation in five patients with refractory angioimmunoblastic T-cell lymphoma complicated by hemophagocytic lymphohistiocytosis: a case series].

The clinical data of five patients with refractory angioimmunoblastic T-cell lymphoma (AITL) complicated by hemophagocytic lymphohistiocytosis (HLH) who underwent salvage allogeneic hematopoietic stem cell transplantation (allo-HSCT) at the Department of Hematology, First Affiliated Hospital of Soochow University, between January 2020 and June 2023 were retrospectively analyzed. The five patients included three men and two women, with a median age of 42 (range, 25-51) years; two had HLH at initial diagnosis, and three developed HLH during treatment. Before allo-HSCT, HLH was controlled and AITL was in partial remission in all five patients; however, three relapsed after undergoing autologous hematopoietic stem cell transplantation during partial remission, whereas two proceeded directly to allo-HSCT. Hematopoietic engraftment was achieved in all five patients, with median neutrophil and platelet engraftment times of 12 (range, 10-15) days and 22 (range, 18-28) days, respectively. Three patients developed infection-related complications, and no case of acute or chronic graft-versus-host disease was observed. As of March 2026, three patients remained alive in complete remission, one had died of a central nervous system fungal infection 1 year after allo-HSCT, and one had died of intracranial hemorrhage 1 year after allo-HSCT. Early salvage allo-HSCT, performed after HLH has been controlled and AITL has achieved a partial response, may provide durable disease control in selected patients. Allo-HSCT may therefore be considered a salvage treatment option for these patients.