title: Hematopoietic cell transplantation for systemic mature T-cell non-Hodgkin lymphoma.
abstract: OBJECTIVE
  To analyze outcomes of hematopoietic cell transplantation (HCT) in T-cell non-Hodgkin lymphoma.
  
  
  METHODS
  Outcomes of 241 patients (112 anaplastic large-cell lymphoma, 102 peripheral T-cell lymphoma not otherwise specified, 27 angioimmunoblastic T-cell lymphoma) undergoing autologous HCT (autoHCT; n = 115; median age, 43 years) or allogeneic HCT (alloHCT; n = 126; median age, 38 years) were analyzed. Primary outcomes were nonrelapse mortality (NRM), relapse/progression, progression-free survival (PFS), and overall survival (OS). Patient, disease, and HCT-related variables were analyzed in multivariate Cox proportional hazard models to determine association with outcomes.
  
  
  RESULTS
  AutoHCT recipients were more likely in first complete remission (CR1; 35% v 14%; P = .001) and with chemotherapy-sensitive disease (86% v 60%; P < .001), anaplastic large-cell histology (53% v 40%; P = .04), and two or fewer lines of prior therapy (65% v 44%; P < .001) compared with alloHCT recipients. Three-year PFS and OS of autoHCT recipients beyond CR1 were 42% and 53%, respectively. Among alloHCT recipients who received transplantations beyond CR1, 31% remained progression-free at 3 years, despite being more heavily pretreated and with more refractory disease. NRM was 3.5-fold higher (95% CI, 1.80 to 6.99; P < .001) for alloHCT. In multivariate analysis, chemotherapy sensitivity (hazard ratio [HR], 1.8; 95% CI, 1.16 to 2.87) and two or fewer lines of pretransplantation therapy (HR, 5.02; 95% CI, 2.15 to 11.72) were prognostic of survival.
  
  
  CONCLUSIONS
  These data describe the roles of autoHCT and alloHCT in T-cell non-Hodgkin lymphoma and suggest greater effectiveness earlier in the disease course, and limited utility in multiply relapsed disease. Notably, autoHCT at relapse may be a potential option for select patients, particularly those with anaplastic large-cell lymphoma histology.
authors.affiliation: University of Chicago Hospitals, Chicago, USA.
authors.forename: Sonali M
authors.initials: SM
authors.lastname: Smith
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Burns
authors.forename: Koen
authors.initials: K
authors.lastname: van Besien
authors.forename: Jennifer
authors.initials: J
authors.lastname: Lerademacher
authors.forename: Wensheng
authors.initials: W
authors.lastname: He
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Fenske
authors.forename: Ritsuro
authors.initials: R
authors.lastname: Suzuki
authors.forename: Jack W
authors.initials: JW
authors.lastname: Hsu
authors.forename: Harry C
authors.initials: HC
authors.lastname: Schouten
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Hale
authors.forename: Leona A
authors.initials: LA
authors.lastname: Holmberg
authors.forename: Anna
authors.initials: A
authors.lastname: Sureda
authors.forename: Cesar O
authors.initials: CO
authors.lastname: Freytes
authors.forename: Richard Thomas
authors.initials: RT
authors.lastname: Maziarz
authors.forename: David J
authors.initials: DJ
authors.lastname: Inwards
authors.forename: Robert Peter
authors.initials: RP
authors.lastname: Gale
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Gross
authors.forename: Mitchell S
authors.initials: MS
authors.lastname: Cairo
authors.forename: Luciano J
authors.initials: LJ
authors.lastname: Costa
authors.forename: Hillard M
authors.initials: HM
authors.lastname: Lazarus
authors.forename: Peter H
authors.initials: PH
authors.lastname: Wiernik
authors.forename: Dipnarine
authors.initials: D
authors.lastname: Maharaj
authors.forename: Ginna G
authors.initials: GG
authors.lastname: Laport
authors.forename: Silvia
authors.initials: S
authors.lastname: Montoto
authors.forename: Parameswaran N
authors.initials: PN
authors.lastname: Hari
mesh_terms: D000293:Adolescent; D000328:Adult; D000077548:Anaplastic Lymphoma Kinase; D002648:Child; D002675:Child, Preschool; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016411:Lymphoma, T-Cell, Peripheral / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020794:Receptor Protein-Tyrosine Kinases / Q000032:analysis; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D000077548:Anaplastic Lymphoma Kinase; D020794:Receptor Protein-Tyrosine Kinases
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