Graft-Versus-Lymphoma Effect in Relapsed Peripheral T-Cell Non-Hodgkin's Lymphomas After Reduced-Intensity Conditioning Followed by Allogeneic Transplantation of Hematopoietic Cells

Corradini, Paolo; Dodero, Anna; Zallio, Francesco; Caracciolo, Daniele; Casini, Marco; Bregni, Marco; Narni, Franco; Patriarca, Francesca; Boccadoro, Mario; Benedetti, Fabio; Rambaldi, Alessandro; Gianni, Alessandro M.; Tarella, Corrado

doi:10.1200/jco.2004.12.050

Cited by 290 publications

(201 citation statements)

References 15 publications

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“…15,35,36 Similarly, Corradini et al 35 reported 17 patients with relapsed or refractory disease who underwent a reduced intensity allogeneic procedure. The authors found an impressive OS of 80% and PFS of 60% at 3 years.…”

Section: Allo-hsct For Ptclmentioning

confidence: 99%

Hematopoietic SCT for peripheral T-cell lymphoma

Gutiérrez

Caballero

Perez-Manga

et al. 2008

Bone Marrow Transplant

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Results of conventional chemotherapy for high-risk peripheral T-cell lymphoma (PTCL) are poor compared with those for their aggressive B-cell counterparts. We aim to review the current data on the use of hematopoietic SCT in these patients in both frontline and salvage settings. With respect to autologous SCT (ASCT), conclusions from retrospective studies are that ASCT in the salvage setting is as useful in PTCL as in aggressive B-cell lymphomas and also that consolidation in first complete response of high-risk patients has very good results when compared with conventional chemotherapy (with long-term PFS higher than 50%). From first frontline prospective clinical trials, it appears that ASCT is feasible and has a low TRM (o5%); consolidation in first complete response is associated with a very good outcome; around 25% of patients do not undergo ASCT due mainly to disease progression; new approaches aimed at increasing the number of chemosensitive patients should be found. Furthermore, 25-30% of patients deemed complete responders post transplant still relapse afterward. For all these mainly chemoresistant patients, there is preliminary evidence that allogeneic SCT (Allo-SCT) may produce a plateau in survival curves (with long-term PFS around 50%), which indicates a graft-versus-PTCL effect. For this reason, Allo-SCT procedures are the object of ongoing clinical trials.

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Section: Allo-hsct For Ptclmentioning

confidence: 99%

Hematopoietic SCT for peripheral T-cell lymphoma

Gutiérrez

Caballero

Perez-Manga

et al. 2008

Bone Marrow Transplant

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“…[1][2][3] RIC regimens also have been investigated in patients with aggressive lymphomas: Most of those studies included various B-cell and T-cell histotypes, and the estimated 3-year PFS rates have been 15% to 20% in patients with chemoresistant disease and 45% to 55% in patients with chemosensitive disease. [4][5][6][7] Chemosensitivity is 1 of the most important prognostic factors affecting final outcomes in patients who receive myeloablative conditioning, and is also important for patients who receive RIC regimens. We recently demonstrated better overall survival (OS) and PFS in patients with lymphoma who underwent an allograft in complete remission compared with the survival of patients who underwent transplantation in partial remission or with refractory disease.…”

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confidence: 99%

Pretransplantation [18‐F]fluorodeoxyglucose positron emission tomography scan predicts outcome in patients with recurrent Hodgkin lymphoma or aggressive non‐Hodgkin lymphoma undergoing reduced‐intensity conditioning followed by allogeneic stem cell transplantation

Dodero

Crocchiolo

Miceli

et al. 2010

Cancer

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BACKGROUND:The use of positron emission tomography (PET) scanning in Hodgkin lymphoma (HL) and aggressive non-Hodgkin lymphoma (HG-NHL) has recognized prognostic value in patients who are receiving chemotherapy or undergoing autologous stem cell transplantation (SCT). In contrast, the role of PET before reduced-intensity conditioning (RIC) and followed by allogeneic SCT has not been investigated to date. METHODS: PET was used to assess 80 patients who had chemosensitive disease (34 patients with HG-NHL and 46 patients with HL) before they underwent allogeneic SCT: 42 patients had negative PET studies, and 38 patients had positive PET studies. Patients underwent allograft from matched related siblings (n ¼ 41) or alternative donors (n ¼ 39). RESULTS: At the time of the last follow-up, 48 patients were alive (60%), and 32 had died. The 3-year cumulative incidence of nonrecurrence mortality and disease recurrence was 17% and 40%, respectively. The cumulative incidence of disease recurrence was significantly lower in the PET-negative patients (25% vs 56%; P ¼ .007), but there was no significant difference between the patients with or without chronic graft-versus-host disease (P ¼ .400). The patients who had negative PET studies before undergoing allogenic SCT also had significantly better outcomes in terms of 3-year overall survival (76% vs 33%; P ¼ .001) and 3-year progression-free survival (73% vs 31%; P ¼ .001). On multivariate analysis, overall survival was influenced by PET status (hazard ratio [HR], 3.35), performance status (HR, 5.15), and type of donor (HR, 6.26 for haploidentical vs sibling; HR, 1.94 for matched unrelated donor vs sibling). CONCLUSIONS: The current results indicated that PET scanning appears to be an accurate tool for assessing prognosis in patients who are eligible for RIC allografting. Cancer 2010;116:5001-11.

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“…First, relatively good results have been obtained with RIC, 12 likely more to an immunological effect than to more-intensive chemotherapy. Second, in most studies the survival curve stabilized after 12-18 months, suggesting a possible curative effect.…”

Section: Introductionmentioning

confidence: 99%

“…2 Allogenic SCT (allo-SCT) is increasingly used as an alternative strategy, based on a potent graft-versus-lymphoma effect (GvL). However, data from retrospective [3][4][5][6][7][8][9][10][11] and prospective non-randomized studies 12 are insufficient to recommend allo-SCT as first-line treatment. The European Bone Marrow Transplantation Society currently considers allo-SCT to be an option for selected patients with chemosensitive disease in first or second complete response (CR), if a sibling or unrelated HLA-matched donor is available (grade 2 recommendations).…”

Section: Introductionmentioning

confidence: 99%

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)

Mamez

Lévy

Chevallier

et al. 2015

Bone Marrow Transplant

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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 nonimmunologic 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.

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Graft-Versus-Lymphoma Effect in Relapsed Peripheral T-Cell Non-Hodgkin's Lymphomas After Reduced-Intensity Conditioning Followed by Allogeneic Transplantation of Hematopoietic Cells

Abstract: RIC followed by allogeneic stem-cell transplantation is feasible, has a low treatment-related mortality, and seems to be a promising salvage treatment for relapsed PTCL. These findings suggest that the existence of a graft-versus-T-cell lymphoma effect.

Cited by 290 publications

References 15 publications

Hematopoietic SCT for peripheral T-cell lymphoma

Hematopoietic SCT for peripheral T-cell lymphoma

Pretransplantation [18‐F]fluorodeoxyglucose positron emission tomography scan predicts outcome in patients with recurrent Hodgkin lymphoma or aggressive non‐Hodgkin lymphoma undergoing reduced‐intensity conditioning followed by allogeneic stem cell transplantation

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)

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