Allogeneic stem cell transplantation in patients with aggressive primary cutaneous T‐cell lymphoma – a case series of the ADF working group „cutaneous lymphomas”

Abstract

Background: Allogeneic stem cell transplantation (alloSCT) is a treatment option for primary cutaneous T-cell lymphomas that may induce long-lasting complete remissions. Little information is available on safety and efficacy. Patients and methods: We retrospectively reviewed the data from patients with primary cutaneous T-cell lymphoma treated in the Departments of Dermatology of the Universities of Bochum, Mannheim and Cologne who received subsequent alloSCT between 2005 and 2012. Results: Nine patients with aggressive primary cutaneous T-cell-lymphoma received alloSCT. With a follow-up of 14 to 36 months after transplantation, 4 patients are alive and in complete remission. Two patients had recurrent disease post-transplantation, which was successfully treated with donor lymphocyte infusions. Non-relapse mortality was observed in three patients in advanced disease stages within six months after alloSCT. One patient showed only partial remission and died of disease after 32 months and one patient died 26 months after alloSCT with cause of death unknown. Conclusions: This report documents the possible benefit of a graft-versus-lymphoma effect in primary cutaneous T-cell lymphoma, as has been observed for other T-cell malignancies and emphasizes that alloSCT warrants further studies in this setting.

Hematopoietic stem cell transplantation in advanced cutaneous T‐cell lymphoma

“…To date, nine patients with PCALCL have been reported to receive HSCT . In a 21‐year‐old female patient, CR was achieved with anti‐CD30 monoclonal antibody administrated more than 1 year after relapse of PCALCL following autologous HSCT .…”

“…To date, only eight patients with PCAETCL have been reported to receive HSCT . Of these, four underwent allogeneic HSCT: two were alive in CR, whereas the other two died due to disease progression.…”

“…To date, six patients with MF/SS have been reported to undergo DLI after allogeneic HSCT . Of these, three patients achieved CR, two obtained PR and one died of the disease after DLI . DLI seems to be effective in the treatment of post‐transplant relapse of MF/SS.…”

“…Although advanced CTCL is expected to be well managed with HSCT, no clinical trials have been conducted owing to the rarity of the condition. However, several retrospective studies on HSCT in patients with advanced CTCL have been conducted; nonetheless, most of these studies included only MF and SS …”

“…However, several retrospective studies on HSCT in patients with advanced CTCL have been conducted; nonetheless, most of these studies included only MF and SS. 6,7 At our university hospital, for patients with advanced CTCL eligible for HSCT, autologous HSCT is selected when they respond well to chemotherapy, while allogeneic HSCT is selected for patients with advanced MF/SS and CTCL other than MF/SS who show poor chemosensitivity. We retrospectively evaluated data from five patients with advanced CTCL, who underwent autologous or allogeneic HSCT.…”