title: Effect of immune modulation in relapsed peripheral T-cell lymphomas after post-allogeneic stem cell transplantation: a study by the Société Française de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC).
abstract: Peripheral T-cell lymphoma carries a poor prognosis. To document a possible graft-versus-lymphoma effect in this setting, we evaluated the impact of immunomodulation in 63 patients with peripheral T-cell lymphoma who relapsed after allogeneic transplant in 27 SFGM-TC centers. Relapse occurred after a median of 2.8 months. Patients were then treated with non-immunologic strategies (chemotherapy, radiotherapy) and/or immune modulation (donor lymphocyte infusions (DLI) and/or discontinuation of immunosuppressive therapy). Median overall survival (OS) after relapse was 6.1 months (DLI group: 23.6 months, non-DLI group: 3.6 months). Among the 14 patients who received DLI, 9 responded and 2 had stable disease. Among the remaining 49 patients, a complete response accompanied by extensive chronic GvHD was achieved in two patients after tapering of immunosuppressive drugs. Thirty patients received radio-chemotherapy, with an overall response rate of 50%. In multivariate analysis, chronic GvHD (odds ratio: 11.25 (2.68-48.21), P=0.0009) and skin relapse (odds ratio: 4.15 (1.04-16.50), P=0.043) were associated with a better response to treatment at relapse. In a time-dependent analysis, the only factor predictive of OS was the time from transplantation to relapse (hazards ratio: 0.33 (0.17-0.640), P=0.0009). This large series provides encouraging evidence of a true GvL effect in this disease.
authors.affiliation: Service d'hématologie, Hôpital Saint Antoine, 184 rue du faubourg Saint Antoine, Paris, France.
authors.forename: A C
authors.initials: AC
authors.lastname: Mamez
authors.affiliation: Unité de Recherche Clinique, Hôpital Avicenne, Bobigny, Cedex, France.
authors.forename: V
authors.initials: V
authors.lastname: Lévy
authors.affiliation: Service d'hématologie, CHU Nantes, 1 Place Alexis-Ricordeau, Nantes, France.
authors.forename: P
authors.initials: P
authors.lastname: Chevallier
authors.affiliation: Service d'hématologie, Institut Paoli Calmette, Marseille, France.
authors.forename: D
authors.initials: D
authors.lastname: Blaise
authors.affiliation: Hôpital du Haut Lévêque Service d'Hématologie, Pessac, France.
authors.forename: S
authors.initials: S
authors.lastname: Vigouroux
authors.affiliation: Service d'hématologie, greffe de moelle, Hôpital Saint Louis, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Xhaard
authors.affiliation: Service d'hématologie, CHU Montpellier, 191 avenue du Doyen Gaston Giraud, Montpellier, France.
authors.forename: N
authors.initials: N
authors.lastname: Fegueux
authors.affiliation: Service d'hématologie, CHU Rouen, Rue d'Amiens, Cedex 1, France.
authors.forename: N
authors.initials: N
authors.lastname: Contentin
authors.affiliation: University of Liège, Department of Hematology, CHU Sart-Tilman, CHU de Liège, Domaine Universitaire du Sart Tilman, Liège 1, Belgium.
authors.forename: Y
authors.initials: Y
authors.lastname: Beguin
authors.affiliation: Service d'hématologie, CHU, Angers, France 4 Rue Larrey, Angers, France.
authors.forename: N
authors.initials: N
authors.lastname: Ifrah
authors.affiliation: Service d'hématologie, CHU Grenoble, boulevard de la Chantourne, Grenoble cedex 09, France.
authors.forename: C E
authors.initials: CE
authors.lastname: Bulabois
authors.affiliation: Service d'hématologie, Hôpital Necker, Paris, France.
authors.forename: F
authors.identifier: http://orcid.org/0000-0002-3537-9052
authors.initials: F
authors.lastname: Suarez
authors.affiliation: Service d'hématologie, CHRU Lille, 2 avenue Oscar Lambret, CEDEX, France.
authors.forename: I
authors.initials: I
authors.lastname: Yakoub-Agha
authors.affiliation: Service d'hématologie, CHU Dupuytren, Limoges cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Turlure
authors.affiliation: Service d'hématologie, CHRU Besançon, 2 boulevard Fleming, Besançon, France.
authors.forename: E
authors.initials: E
authors.lastname: Deconink
authors.affiliation: Service d'hématologie, CHU Rennes, 2 rue Henri Le Guilloux, cedex 9, France.
authors.forename: T
authors.initials: T
authors.lastname: Lamy
authors.affiliation: Service d'hématologie, CHU Grenoble, boulevard de la Chantourne, Grenoble cedex 09, France.
authors.forename: J Y
authors.initials: JY
authors.lastname: Cahn
authors.affiliation: Service d'hématologie, CHU Purpan, Place du Dr Baylac, Toulouse, France.
authors.forename: A
authors.initials: A
authors.lastname: Huynh
authors.affiliation: Service d'hématologie, Hôpital Henri Mondor, Créteil, France.
authors.forename: S
authors.initials: S
authors.lastname: Maury
authors.affiliation: Service d'hématologie, CHRU Strasbourg, Hôpital Hautepierre, Strasbourg, France.
authors.forename: L M
authors.initials: LM
authors.lastname: Fornecker
authors.affiliation: Service d'hématologie, Hematologie Clinique, Hôpital Pitié Salpêtrière, boulevard de l'Hôpital, Paris cedex 13, France.
authors.forename: M
authors.initials: M
authors.lastname: Ouzegdouh
authors.affiliation: Service d'hématologie, Hôpital d'Estaing, CHU Clermond Ferrand,1 place Lucie-Aubrac, Clermont-Ferrand Cedex 1, France.
authors.forename: J O
authors.initials: JO
authors.lastname: Bay
authors.affiliation: Service d'hématologie, CHU Brest, Hôpital Morvan, Cedex, France.
authors.forename: G
authors.initials: G
authors.lastname: Guillerm
authors.affiliation: Service d'hématologie, CHU Poitiers, CHRU La Miletrie, Poitiers Cedex, France.
authors.forename: N
authors.initials: N
authors.lastname: Maillard
authors.affiliation: Service d'hématologie, CHU Lyon, Centre Hospitalier Lyon-Sud 165 chemin du Grand Revoyet, Pierre Bénite Cedex, France.
authors.forename: M
authors.initials: M
authors.lastname: Michallet
authors.affiliation: Service d'hématologie, Hôpital d'instruction des armées Percy, Clamart, France.
authors.forename: J V
authors.initials: JV
authors.lastname: Malfuson
authors.affiliation: Service d'hématologie, Institut Gustave Roussy, 114 r Edouard Vaillant, Villejuif CEDEX, France.
authors.forename: J H
authors.initials: JH
authors.lastname: Bourhis
authors.affiliation: Service d'hématologie pédiatrique, CHU Nantes, Hôtel Dieu,1 place Alexis-Ricordeau, Nantes, France.
authors.forename: F
authors.initials: F
authors.lastname: Rialland
authors.affiliation: Service d'hématologie, CHU Caen, Avenue de la Côte de nacre, Caen cedex 9, France.
authors.forename: R
authors.initials: R
authors.lastname: Oumedaly
authors.affiliation: Service d'hématologie pédiatrique, CHU Bordeaux Pellegrin - Place Amélie Raba Léon, Bordeaux, France.
authors.forename: C
authors.initials: C
authors.lastname: Jubert
authors.affiliation: Service d'hématologie, Hematologie Clinique, Hôpital Pitié Salpêtrière, boulevard de l'Hôpital, Paris cedex 13, France.
authors.forename: V
authors.initials: V
authors.lastname: Leblond
authors.affiliation: Unité de Recherche Clinique, Hôpital Avicenne, Bobigny, Cedex, France.
authors.forename: M
authors.initials: M
authors.lastname: Boubaya
authors.affiliation: Service d'hématologie, Hôpital Saint Antoine, 184 rue du faubourg Saint Antoine, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Mohty
authors.affiliation: Service d'hématologie, Hematologie Clinique, Hôpital Pitié Salpêtrière, boulevard de l'Hôpital, Paris cedex 13, France.
authors.forename: S
authors.initials: S
authors.lastname: Nguyen
mesh_terms: D000328:Adult; D064591:Allografts; D059248:Chemoradiotherapy; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D017710:Lymphocyte Transfusion; D016411:Lymphoma, T-Cell, Peripheral / Q000401:mortality / Q000628:therapy; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D007166:Immunosuppressive Agents