A large single-center experience with allogeneic stem-cell transplantation for peripheral T-cell non-Hodgkin lymphoma and advanced mycosis fungoides/Sezary syndrome.
BACKGROUND
The prognosis for patients with most forms of T-cell lymphoma is poor. Allogeneic hematopoietic stem-cell transplantation (HSCT) may improve the outcome.


METHODS
This study examines the outcome of 52 patients who underwent ablative or nonablative allogeneic HSCT for peripheral T-cell lymphoma (PTCL) or advanced mycosis fungoides/Sezary syndrome over a 12-year period at a single institution. We divided the patients into those with predominantly nodal histologies: peripheral T-cell not otherwise specified (PTCL NOS), angioimmunoblastic (AITL), or anaplastic large cell lymphoma, T/null type (systemic) (ALCL), and predominantly extranodal histologies: natural killer (NK)/T cell, enteropathy type, hepatosplenic, subcutaneous panniculitic, mycosis fungoides, or T cell or NK cell other.


RESULTS
Median follow-up of survivors is 49 months. Non-relapse mortality and relapse at 3 years was 27% and 43%, respectively. The incidence of grade II-IV acute graft-versus-host disease (GVHD) was 21%. The incidence of extensive chronic GVHD at 2 years was 27%. The 3-year progression-free survival was 30%: 45% in patients with predominantly nodal histologies (PTCL NOS, AITL, and ALCL) and 6% in patients with predominantly extranodal histologies (P = 0.016). Overall survival at 3 years was 41% for all patients.


CONCLUSIONS
Allogeneic HSCT can produce long-term remissions in relapsed/refractory T-cell lymphoma, especially those with nodal histologies.
Department of Medical Oncology. Electronic address: edjacobsen@partners.org.
E D
ED
Jacobsen
Department of Biostatistics, Dana-Farber Cancer Institute, Boston, USA.
H T
HT
Kim
Department of Medical Oncology.
V T
VT
Ho
Department of Medical Oncology.
C S
CS
Cutler
Department of Medical Oncology.
J
J
Koreth
Department of Medical Oncology.
D C
DC
Fisher
Department of Medical Oncology.
P
P
Armand
Department of Medical Oncology.
E P
EP
Alyea
Department of Medical Oncology.
A S
AS
Freedman
Department of Medical Oncology.
R J
RJ
Soiffer
Department of Medical Oncology.
J H
JH
Antin
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000209:etiology* / Q000628:therapy; D006801:Humans; D016411:Lymphoma, T-Cell, Peripheral / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000150:complications / Q000628:therapy*; D012751:Sezary Syndrome / Q000150:complications / Q000628:therapy*; D012878:Skin Neoplasms / Q000150:complications / Q000628:therapy*; D033581:Stem Cell Transplantation; D015996:Survival Rate; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
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