StemCell Therapy

Allogeneic hematopoietic stem cell transplant (allo-HSCT) may be a curative option for some patients with relapsed/refractory T-cell lymphoma (TCL), according to results of a retrospective study presented at the virtual 62nd American Society of Hematology (ASH) Annual Meeting and Exposition.

Outcomes from previous registry studies suggest that only about one-third of patients with relapsed TCL are disease-free 3 years after allo-HSCT, including a prior study by this same group of researchers, which found the 2-year PFS and OS to be 48.9% and 61.7%, respectively.

The group conducted the current study to better understand the dynamics of allogeneic transplant in T-cell lymphoma and with longer follow-up, Neha Mehta-Shah, MD, of the Washington University School of Medicine in St. Louis, Missouri, and presenter of the study, said.

The retrospective study included 508 consecutive patients with TCL who underwent allo-HSCT between 2000 and 2019 across 12 academic institutions. The median age of patients in the cohort was 51 years, and at the time of transplant, 54.4% were in complete remission (CR), 37.2% were in partial remission (PR), 5% had stable disease, and 3.2% had progressive disease. There were 15.5% of patients who had undergone prior autologous transplant. The conditioning regimens used prior to transplant were myeloablative in 35.4%, reduced intensity/nonmyeloablative in 63.6%, and unknown in less than 1% of patients.

After allo-HSCT, the 2- and 5-year progression-free survival (PFS) rates were 45.8% and 39.4%, respectively.

The time from relapse to death post allo-HSCT was a median 10.2 months. The 2- and 5-year overall survival (OS) was 59.1% and 50.8%, respectively. Among the 261 deaths that were recorded, 31% were transplant-related, 26.4% were due to progressive disease, and 42.5% were nonrelapse-related and/or unknown.

PFS was similar among patients with the angioimmunoblastic, not otherwise specified, and ALK-positive or -negative anaplastic large cell subtypes. Although PFS outcomes were worse for patients with cutaneous TCL (P =.0008), OS outcomes were not significantly different from other TCL subtypes (44% for cutaneous TCL vs 53.1% for others; P =.4573).

CR at the time of transplant was associated with longer median PFS and OS, with progressive disease associated with the shortest PFS and OS.

Dr Mehta-Shah concluded that in the largest series of allogeneic transplant to date, allogeneic transplant for patients with TCL can lead to durable remissions in patients with otherwise poor outcomes.

Disclosures: Some of the presenters disclosed financial relationships with the pharmaceutical industry and/or the medical device industry. For a full list of disclosures, please refer to the presentation abstract.

Read more of Cancer Therapy Advisors coverage of the ASH 2020 meeting by visiting the conference page.

Reference

Mehta-Shah N, Kommalapati A, Teja S, et al. Successful treatment of mature T-cell lymphoma with allogeneic stem cell transplantation: the largest multicenter retrospective analysis. Presented at: 62nd American Society of Hematology (ASH) Annual Meeting and Exposition; virtual; December 5-9, 2020. Abstract 41.

Read more:
HSCT Found Potentially Curative for Some T-Cell Lymphoma Patients - Cancer Therapy Advisor

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