title: Allogeneic stem-cell transplantation in patients with cutaneous lymphoma: updated results from a single institution.
abstract: BACKGROUND
  Cutaneous T-cell lymphomas (CTCLs) and its common variants mycosis fungoides (MF) and leukemic Sézary syndrome (SS) are rare extranodal non-Hodgkin's lymphomas. Patients who present with advanced disease and large-cell transformation (LCT) are incurable with standard treatments. In this article, we report the largest single-center experience with allogeneic stem-cell transplantation (SCT) for advanced CTCL.
  
  
  METHODS
  This is a prospective case series of 47 CTCL patients who underwent allogeneic SCT after failure of standard therapy between July 2001 and September 2013. The Kaplan-Meier method was used to estimate overall survival (OS) and progression-free survival (PFS) curves. The method of Fine and Gray was used to fit regression models to the same covariates for these cumulative incidence data.
  
  
  RESULTS
  The Kaplan-Meier estimates of OS and PFS at 4 years were 51% and 26%, respectively. There was no statistical difference in the OS in patients who had MF alone, SS, MF with LCT, or SS with LCT. PFS at 4 years was superior in patients who had SS versus those who did not (52.4% versus 9.9%; P = 0.02). The cumulative incidences of grade 2-4 acute graft-versus-host disease (GVHD) and chronic GVHD were 40% and 28%, respectively. The cumulative nonrelapse mortality rate was 16.7% at 2 years.
  
  
  CONCLUSIONS
  Allogeneic SCT may result in long-term remissions in a subset of patients with advanced CTCL. Although post-SCT relapse rates are high, many patients respond to immunomodulation and achieve durable remissions.
  
  
  BACKGROUND
  NCT00506129.
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy cmhosing@mdanderson.org.
authors.forename: C
authors.initials: C
authors.lastname: Hosing
authors.affiliation: Department of Biostatistics.
authors.forename: R
authors.initials: R
authors.lastname: Bassett
authors.affiliation: Department of Radiation Oncology.
authors.forename: B
authors.initials: B
authors.lastname: Dabaja
authors.affiliation: Department of Dermatology.
authors.forename: R
authors.initials: R
authors.lastname: Talpur
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy.
authors.forename: A
authors.initials: A
authors.lastname: Alousi
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy.
authors.forename: S
authors.initials: S
authors.lastname: Ciurea
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy.
authors.forename: U
authors.initials: U
authors.lastname: Popat
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy.
authors.forename: M
authors.initials: M
authors.lastname: Qazilbash
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy.
authors.forename: E J
authors.initials: EJ
authors.lastname: Shpall
authors.affiliation: Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston.
authors.forename: Y
authors.initials: Y
authors.lastname: Oki
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy.
authors.forename: Y
authors.initials: Y
authors.lastname: Nieto
authors.affiliation: Department of Radiation Oncology.
authors.forename: C
authors.initials: C
authors.lastname: Pinnix
authors.affiliation: Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston.
authors.forename: M
authors.initials: M
authors.lastname: Fanale
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy.
authors.forename: F
authors.initials: F
authors.lastname: Maadani
authors.affiliation: Department of Blood and Marrow Transplantation, John Theurer Cancer Center, Hackensack, USA.
authors.forename: M
authors.initials: M
authors.lastname: Donato
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy.
authors.forename: R
authors.initials: R
authors.lastname: Champlin
authors.affiliation: Department of Dermatology.
authors.forename: M
authors.initials: M
authors.lastname: Duvic
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods* / Q000639:trends; D006801:Humans; D016410:Lymphoma, T-Cell, Cutaneous / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D014184:Transplantation, Homologous / Q000379:methods / Q000639:trends; D055815:Young Adult
keywords: Sézary syndrome; allogeneic stem-cell transplantation; cutaneous T-cell lymphoma; mycosis fungoides