Allogeneic hematopoietic stem cell transplantation in Primary Cutaneous T Cell Lymphoma

William Arcese for the Rome Transplant Network

Research output: Contribution to journalArticle

Abstract

In our retrospective study, 16 patients affected by advanced cutaneous T cell lymphoma (CTCL) underwent allogeneic hematopoietic stem cell transplantation (HSCT). Two patients (12.5%) were in complete remission (CR), nine (56.3%) in partial remission (PR), and five (31.2%) with active disease. The patients were transplanted from an HLA-identical (n = 7) from a mismatched (n = 1) or haploidentical (n = 1) sibling, from matched unrelated donor (n = 5), or from a single cord blood unit (n = 2). Conditioning regimen was standard myeloablative in 6 patients and at reduced intensity in 10. Seven patients died from non relapse mortality (NRM) and four patients relapsed or progressed, three of them achieved a second CR after donor lymphocyte infusion (DLI) or chemotherapy plus DLI. To date, with a median follow-up of 76 months (range 6-130), nine patients are alive, eight in CR, and one with active disease. Overall survival (OS) and disease-free survival (DFS) at 1 and 10 years are 61% (95% CI 40-91%) and 54% (95% CI 33-86%), 40% (95% CI 22-74%), and 34% (95% CI 16-68%), respectively. The time from diagnosis to transplant seems to influence negatively both OS (log-rank p < 0.04) and DFS (log-rank p < 0.05). Our results confirm on a long follow-up that CTCL appears particularly susceptible to the graft versus lymphoma (GVL) effect, so that allogeneic HSCT represents a possibility of cure for advanced CTCL. The timing of HSCT in the clinical course of disease remains an open issue.

Original languageEnglish
Pages (from-to)1041-1048
Number of pages8
JournalAnnals of Hematology
Volume97
Issue number6
DOIs
Publication statusPublished - Jun 2018

Keywords

  • Adult
  • Aged
  • Cancer Care Facilities
  • Cohort Studies
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Graft vs Host Disease/epidemiology
  • Graft vs Tumor Effect
  • Hematopoietic Stem Cell Transplantation/adverse effects
  • Humans
  • Incidence
  • Italy/epidemiology
  • Lymphoma, T-Cell, Cutaneous/epidemiology
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Remission Induction
  • Retrospective Studies
  • Risk
  • Secondary Prevention
  • Severity of Illness Index
  • Survival Analysis
  • Transplantation, Homologous/adverse effects
  • Young Adult

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