Allogeneic haematopoietic stem cell transplant (allo-HSCT) may be a treatment option for some relapsed / refractory T-cell lymphoma (TCL) patients, according to a retrospective study presented on the virtual 62nd year of the American Society of Hematology (ASH) Meeting and Exposure .
Results from previous registry studies suggest that only about a third of patients with relapsed TCL are disease free 3 years after allo-HSCT, including an earlier study by the same group of investigators that found 2-year PFS and OS as 48.9% and 61.7%.
The group conducted the current study “to better understand the dynamics of allograft in T-cell lymphoma and with longer follow-up,” Dr. Neha Mehta-Shah of Washington University School of Medicine in St. Louis, Missouri and the study presenter, he said.
The retrospective study included 508 consecutive TCL patients who underwent allo-HSCT between 2000 and 2019 in 12 academic institutions. The median age of the patients in the cohort was 51 years, and at the time of transplantation, 54.4% were in complete remission (CR), 37.2% in partial remission (PR), 5% had stable disease, and 3.2% had progression. disease. There were 15.5% of patients who had had a prior autologous transplant. The pre-transplant conditioning regimens were myeloablative in 35.4%, reduced intensity / non-myeloablative 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 median time from relapse to death after allo-HSCT was 10.2 months. The 2- and 5-year overall survival (OS) was 59.1% and 50.8%, respectively. Of the 261 deaths recorded, 31% were transplant related, 26.4% due to progressive disease, and 42.5% were not related to relapse and / or were unknown.
PFS was similar among patients with angioimmunoblastic, unspecified, and ALK-positive or negative anaplastic large cell subtype. Although PFS scores were worse in patients with cutaneous TCL (P. = 0.0008), OS results did not differ significantly from other TCL subtypes (44% for cutaneous TCL vs 53.1% for others; P. = 0.4573).
CR at the time of transplantation was associated with longer medians of PFS and OS, with progressive disease associated with the shortest PFS and OS.
Dr. Mehta-Shah concluded that “in the largest series of allografts to date, allograft in TCL patients may lead to sustained remission in patients with poor outcomes.”
Disclosures: Some presenters revealed financial ties to the pharmaceutical and / or medical device industries. For a complete list of information disclosed, please see the presentation summary.
Read more Cancer Therapy Advisorreport from the ASH 2020 meeting on the conference website.
Mehta-Shah N, Kommalapati A, Teja S et al. Successful treatment of mature T cell lymphoma with allogeneic stem cell transplantation: the largest multicentre retrospective analysis. Featured at: American Society of Hematology (ASH) 62nd Annual Meeting and Exhibition; virtual; 5-9 December 2020 Executive Summary 41.