Outcome of Allogeneic and Autologous Hematopoietic Cell Transplantation for High-Risk Peripheral T Cell Lymphomas: A Retrospective Analysis From a Chinese Center

Abstract

Peripheral T cell lymphomas (PTCLs) often carry poor outcomes with conventional chemotherapy, and hematopoietic cell transplantation (HCT) can benefit patients with PTCL. We conducted a retrospective review of 67 patients with PTCL who underwent autologous HCT (autoHCT, n = 43; median age, 40 years) or allogeneic HCT (alloHCT, n = 24; median age, 36.5 years) from 2004 to 2016. With a median follow-up of 27 months, 5-year progression-free survival (PFS) and overall survival (OS) of autoHCT patients were 49% and 57%, respectively. Among alloHCT recipients, the 5-year PFS and OS were 54% and 55%, respectively. When considering incidence of disease relapse or progression (CIR) and nonrelapse mortality (NRM), the 5-year CIR and 1-year NRM of alloHCT recipients were 38% and 18%, respectively, and 58% and 7% for autoHCT patients, respectively. There were no differences between autoHCT and alloHCT in 5-year PFS (P = .499), OS (P = .566), CIR (P = .555), and NRM (P = .202). When specifically examining recipients in primary refractory disease, 3-year PFS rates of autoHCT and alloHCT were 20% and 49% (P = .054); 3-year OS rates were 20% and 53% (P = .042), respectively. Based on these results, we favor proceeding to alloHCT in patients with PTCL in primary refractory disease.

Comparison of Allogeneic Stem Cell Transplant and Autologous Stem Cell Transplant in Refractory or Relapsed Peripheral T-Cell Lymphoma

“…Sixteen trials 5 , 13 , 14 , 15 , 16 , 18 , 19 , 22 , 23 , 26 , 27 , 30 , 31 , 32 , 35 , 39 with 1002 patients reported OS at 3 years. Nine trials 13 , 14 , 15 , 16 , 18 , 19 , 22 , 23 , 26 with 388 patients were assessed for 3-year OS ( I 2 = 71%) in the allogeneic HSCT group, and the pooled 3-year OS was 50% (95% CI, 41%-60%) for all patients with R/R-PTCL treated with allogeneic HSCT. The autologous HSCT group included 9 studies 5 , 16 , 18 , 27 , 30 , 31 , 32 , 35 , 39 with 614 patients, and the pooled 3-year OS was 55% (95% CI, 48%-64%).…”

“…(n = 43), 16 indicating that favorable survival outcomes were observed in the allogeneic HSCT group.…”

“…In addition, 115 patients with R/R-PTCL undergoing autologous HSCT had a 3-year OS of 59%, 3-year PFS of 47%, and 3-year NRM of 6%. 18 These 2 trials 16,18 were included in the current study. To identify whether they would affect the conclusions, a sensitivity analysis was performed.…”

“…Nine trials [13][14][15][16]18,19,22,23,26 with 388 patients were assessed for 3-year OS (I 2 = 71%) in the allogeneic HSCT group, and the pooled 3-year OS was 50% (95% CI, 41%-60%) for all patients with R/R-PTCL treated with allogeneic HSCT. The autologous HSCT group included 9 studies 5,16,18,27,[30][31][32]35,39 allogeneic HSCT after 3 years of follow-up. However, on the basis of the pretransplant CR rate of allogeneic HSCT and autologous HSCT, 42.60% vs 63.37% (χ 2 = 47.20, P < .001), which we calculated via SPSS software, version 25.0 (SPSS Inc), we found that the patients undergoing autologous HSCT were commonly sensitive to chemotherapy or experienced their first CR after induction therapy.…”

Current status and progress of lymphoma management in China

“…The 5-year OS rate was 38.5% for all PTCL patients [36]. Frontline consolidation treatment with HDC/ASCT was associated with favourable outcomes in patients with PTCL [37][38][39][40]. CR to induction chemotherapy was a prognostic factor for survival [37][38][39][40].…”