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Lymphoma

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)

Bone Marrow Transplantation volume 51, pages 358–364 (2016)Cite this article

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Abstract

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 non-immunologic 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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Acknowledgements

ACM1 and SN20 designed the study and wrote the paper; VL2 and MB2 performed the statistical analysis, VL2 and MB2 contributed to the analysis of the results, PC, DB, SV, AX, NF, NC, YB, NI, CEB, FS, IYA, PT, ED, TL, JYC, AH, SM, KB, MO, JOB, GG, NM, MM, TD, JHB, FR, RO, CJ contributed to the data collection.

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Authors and Affiliations

  1. Service d’hématologie, Hôpital Saint Antoine, 184 rue du faubourg Saint Antoine, Paris, France

    A-C Mamez & M Mohty

  2. Unité de Recherche Clinique, Hôpital Avicenne, Bobigny, Cedex, France

    V Lévy & M Boubaya

  3. Service d’hématologie, CHU Nantes, 1 Place Alexis-Ricordeau, Nantes,, France

    P Chevallier

  4. Service d’hématologie, Institut Paoli Calmette, Marseille, France

    D Blaise

  5. Hôpital du Haut Lévêque Service d'Hématologie, Pessac, France

    S Vigouroux

  6. Service d’hématologie, greffe de moelle, Hôpital Saint Louis, Paris, France

    A Xhaard

  7. Service d’hématologie, CHU Montpellier, 191 avenue du Doyen Gaston Giraud, Montpellier, France

    N Fegueux

  8. Service d’hématologie, CHU Rouen, Rue d’Amiens, Cedex 1, France

    N Contentin

  9. Department of Hematology, University of Liège, CHU Sart-Tilman, CHU de Liège, Domaine Universitaire du Sart Tilman, Liège 1, Belgium

    Y Beguin

  10. Service d’hématologie, CHU, Angers, France 4 Rue Larrey, Angers, France

    N Ifrah

  11. Service d’hématologie, CHU Grenoble, boulevard de la Chantourne, Grenoble cedex 09, France

    C-E Bulabois & J Y Cahn

  12. Service d’hématologie, Hôpital Necker, Paris, France

    F Suarez

  13. Service d’hématologie, CHRU Lille, 2 avenue Oscar Lambret, CEDEX, France

    I Yakoub-Agha

  14. Service d’hématologie, CHU Dupuytren, Limoges cedex, France

    P Turlure

  15. Service d’hématologie, CHRU Besançon, 2 boulevard Fleming,, Besançon, France

    E Deconink

  16. Service d’hématologie, CHU Rennes, 2 rue Henri Le Guilloux,, cedex 9, France

    T Lamy

  17. Service d’hématologie, CHU Purpan, Place du Dr Baylac,, Toulouse, France

    A Huynh

  18. Service d’hématologie, Hôpital Henri Mondor, Créteil, France

    S Maury

  19. Service d’hématologie, CHRU Strasbourg, Hôpital Hautepierre, Strasbourg, France

    L M Fornecker

  20. Service d’hématologie, Hematologie Clinique, Hôpital Pitié Salpêtrière, boulevard de l'Hôpital,, Paris cedex 13, France

    M Ouzegdouh, V Leblond & S Nguyen

  21. Service d’hématologie, Hôpital d’Estaing, CHU Clermond Ferrand,1 place Lucie-Aubrac,, Clermont-Ferrand Cedex 1, France

    J-O Bay

  22. Service d’hématologie, CHU Brest, Hôpital Morvan, Cedex, France

    G Guillerm

  23. Service d’hématologie, CHU Poitiers, CHRU La Miletrie, Poitiers Cedex, France

    N Maillard

  24. Service d’hématologie, CHU Lyon, Centre Hospitalier Lyon-Sud 165 chemin du Grand Revoyet,, Pierre Bénite Cedex, France

    M Michallet

  25. Service d’hématologie, Hôpital d’instruction des armées Percy, Clamart, France

    J-V Malfuson

  26. Service d’hématologie, Institut Gustave Roussy, 114 r Edouard Vaillant, Villejuif CEDEX, France

    J-H Bourhis

  27. Service d’hématologie pédiatrique, CHU Nantes, Hôtel Dieu,1 place Alexis-Ricordeau, Nantes, France

    F Rialland

  28. Service d’hématologie, CHU Caen, Avenue de la Côte de nacre, Caen cedex 9, France

    R Oumedaly

  29. Service d’hématologie pédiatrique, CHU Bordeaux Pellegrin - Place Amélie Raba Léon, Bordeaux, France

    C Jubert

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  1. A-C Mamez
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  2. V Lévy
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  9. Y Beguin
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  13. I Yakoub-Agha
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  14. P Turlure
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  15. E Deconink
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  16. T Lamy
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  17. J Y Cahn
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  18. A Huynh
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  19. S Maury
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  20. L M Fornecker
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  22. J-O Bay
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  23. G Guillerm
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  24. N Maillard
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  25. M Michallet
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  26. J-V Malfuson
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  29. R Oumedaly
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  30. C Jubert
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  31. V Leblond
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  32. M Boubaya
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  33. M Mohty
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  34. S Nguyen
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Corresponding author

Correspondence to S Nguyen.

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Mamez, AC., Lévy, V., Chevallier, P. et al. 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). Bone Marrow Transplant 51, 358–364 (2016). https://doi.org/10.1038/bmt.2015.280

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  • DOI: https://doi.org/10.1038/bmt.2015.280

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