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Graft Versus Tumor Effects

Graft-versus-lymphoma effect in refractory cutaneous T-cell lymphoma after reduced-intensity HLA-matched sibling allogeneic stem cell transplantation

Bone Marrow Transplantation volume 34, pages 521–525 (2004)Cite this article

Summary:

Cutaneous T-cell lymphomas (CTCL) are rare diseases that, in their advanced stages or in transformation, have a poor prognosis. Autologous stem cell transplantation (Au-SCT) after high-dose therapy has yielded disappointing results. Allogeneic transplantation (allo-SCT) provides the potential advantage of an immune-mediated graft-versus-lymphoma (GVL) effect. Reduced-intensity allo-SCT potentially offers a GVL effect, but with diminished toxicity related to the induction regimen; however, published experience with this approach in CTCL is limited. We report a series of three patients (age 35–49) with advanced, refractory (n=2) or transformed (n=1) CTCL who underwent reduced-intensity allo-SCT in the context of active disease. All three survived the peri-transplant period and, despite later having disease relapse, all exhibited evidence of a GVL effect. Relapses of the disease were in the context of immune suppression for graft-versus-host disease (GVHD), and when immune suppression was reduced, responses were regained. A comparison is made of these results to those in a review of the published literature to date. We conclude that while a GVL can be achieved for CTCL with reduced-intensity allogeneic transplantation, the clinical benefits are short lived and novel approaches are required to obtain sustained remissions.

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Authors and Affiliations

  1. Haematology Service, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia

    K E Herbert, G Ryan, C McCormack & H M Prince

  2. Clinical Haematology and Bone Marrow Transplant, The Alfred Hospital, Melbourne, Victoria, Australia

    A Spencer

  3. Bone Marrow Transplant Service, The Royal Melbourne Hospital, Melbourne, Victoria, Australia

    A Grigg

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  1. K E Herbert
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  2. A Spencer
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  3. A Grigg
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  4. G Ryan
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  5. C McCormack
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  6. H M Prince
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Correspondence to H M Prince.

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Herbert, K., Spencer, A., Grigg, A. et al. Graft-versus-lymphoma effect in refractory cutaneous T-cell lymphoma after reduced-intensity HLA-matched sibling allogeneic stem cell transplantation. Bone Marrow Transplant 34, 521–525 (2004). https://doi.org/10.1038/sj.bmt.1704641

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