Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review
  • Published:

Haematopoietic stem cell transplantation for patients with primary cutaneous T-cell lymphoma

Bone Marrow Transplantation volume 41, pages 597–604 (2008)Cite this article

Abstract

There is no standard of care for patients with advanced forms of mycosis fungoides, Sézary syndrome and other less common subtypes of primary cutaneous T-cell lymphoma. Expected median survival for such patients with conventional therapy is only 1–4 years. As a result of such dismal prognosis, alternative strategies based on autologous and allogeneic transplantation have been explored, and a relatively small number of case reports and small series communicated to date have provided evidence for the potential role of haematopoietic transplantation in these patients. High-dose radio-chemotherapy and autologous rescue has been shown to induce complete responses in the majority of patients. Disappointingly though, these responses were very short-lived in nearly all cases. On the contrary, the use of allogeneic transplantation has provided solid evidence for an allogeneic GVL effect in these malignancies. In fact, more than two-thirds of the allogeneic transplant recipients reported in the literature experienced long-term durable remissions of more than 3 years, which would appear superior to the expected median survival for such patients. This review summarizes the experience published to date in this setting and highlights main areas that would merit further investigation.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Weinstock MA, Horm JW . Mycosis fungoides in the United States. Increasing incidence and descriptive epidemiology. JAMA 1988; 260: 42–46.

    Article  CAS  PubMed  Google Scholar 

  2. Weinstock MA, Gardstein B . Twenty-year trends in the reported incidence of mycosis fungoides and associated mortality. Am J Public Health 1999; 89: 1240–1244.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Willemze R, Jaffe ES, Burg G, Cerroni L, Berti E, Swerdlow SH et al. WHO-EORTC classification for cutaneous lymphomas. Blood 2005; 105: 3768–3785.

    Article  CAS  PubMed  Google Scholar 

  4. Diamandidou E, Cohen PR, Kurzrock R . Mycosis fungoides and Sezary síndrome. Blood 1996; 88: 2385–2409.

    CAS  PubMed  Google Scholar 

  5. Bunn Jr PA, Lamberg SI . Report of the committee on staging and classification of cutaneous T-cell lymphoma. Cancer Treat Rep 1979; 63: 725–728.

    PubMed  Google Scholar 

  6. Kuzel TM, Roenig Jr HH, Rosten ST . Mycosis fungoides and the Sezary syndrome: a review of pathogenesis, diagnosis, and therapy. J Clin Oncol 1991; 9: 1298–1313.

    Article  CAS  PubMed  Google Scholar 

  7. Van Doorn R, van Haselen CW, van Voorst Vader PC, Geerts ML, Heule F, de Rie M et al. Mycosis fungoides: disease evolution and prognosis of 309 Dutch patients. Arch Dermatol 2000; 136: 504–510.

    Article  CAS  PubMed  Google Scholar 

  8. Siegel RS, Pandolfino T, Guitart J, Rosen ST, Kuzel TM . Primary cutaneous T-cell lymphoma: review and current concepts. J Clin Oncol 2000; 115: 798–812.

    Google Scholar 

  9. Whittaker SJ, Marsden JR, Spittle M, Russell-Jones R . Joint British Association of Dermatologists and U.K. Cutaneous Lymphoma Groups guidelines for the management of primary cutaneous T-cell lymphomas. Br J Dermatol 2003; 149: 1095–1107.

    Article  CAS  PubMed  Google Scholar 

  10. Willemze R . Prognostic factors in cutaneous T-cell lymphoma. Haematologica Reports 2006; 2: 89–92.

    Google Scholar 

  11. Olsen E, Vonderheid E, Pimpinelli N, Willemze R, Kim Y, Knobler R et al. Revisions to the staging and classification of mycosis fungoides and Sézary syndrome: a proposal of the International Society for Cutaneous Lymphomas (ISCL) and the cutaneous lymphoma task force of the European Organization of Research and Treatment of Cancer (EORTC). Blood 2007; 110: 1713–1722.

    Article  CAS  PubMed  Google Scholar 

  12. Pichardo DA, Querfeld C, Guitart J, Kuzel TM, Rosen ST . Cutaneous T-cell lymphoma: a paradigm for biological therapies. Leuk Lymphoma 2004; 45: 1755–1765.

    Article  CAS  PubMed  Google Scholar 

  13. Scarisbrick JJ . Staging and management of cutaneous T-cell lymphoma. Clin Exp Dermatol 2006; 31: 181–186.

    Article  CAS  PubMed  Google Scholar 

  14. Trautinger F, Knobler R, Willemze R, Peris K, Stadler R, Laroche L et al. EORTC consensus recommendations for the treatment of mycosis fungoides/Sézary syndrome. Eur J Cancer 2006; 42: 1014–1030.

    Article  PubMed  Google Scholar 

  15. Whittaker SJ, Foss FM . Efficacy and tolerability of currently available therapies for the mycosis fungoides and Sézary syndrome variants of cutaneous T-cell lymphoma. Cancer Treat Rev 2007; 33: 146–160.

    Article  CAS  PubMed  Google Scholar 

  16. Oyama Y, Guitart J, Kuzel TM, Burt RK, Rosen ST . High-dose therapy and bone marrow transplantation in cutaneous T-cell lymphoma. Hematol Oncol Clin North Am 2003; 17: 1475–1483.

    Article  PubMed  Google Scholar 

  17. Schmitz N . Stem cell transplantation in adults: lymphoma. In: Apperley JF, Carreras E, Gluckman E, Gratwohl A, Masszi T (eds). Haematopoietic Stem Cell Transplantation—ESH/EBMT Handbook, 2nd edn, chapter 16.3. Forum Service Editore: Genoa, Italy, 2004, pp 268–275.

    Google Scholar 

  18. Ljungman P, Urbano-Ispizua A, Cavazzana-Calvo M, Demirer T, Dini G, Einsele H et al. Allogeneic and autologous transplantation for haematological diseases, solid tumours and immune disorders: definitions and current practice in Europe. Bone Marrow Transplant 2006; 37: 439–449.

    Article  CAS  PubMed  Google Scholar 

  19. Chen YC, Wang CH, Huang SC, Lee EF, Lin DT, Shen MC et al. Autologous bone marrow transplantation after supralethal dose of total body irradiation in a case of mycosis fungoides. Taiwan Yi Xue Hui Za Zhi 1986; 85: 304–314.

    CAS  PubMed  Google Scholar 

  20. Bigler RD, Crilley P, Micaily B, Brady LW, Topolsky D, Bulova S et al. Autologous bone marrow transplantation for advanced stage mycosis fungoides. Bone Marrow Transplant 1991; 7: 133–137.

    CAS  PubMed  Google Scholar 

  21. Sterling JC, Marcus R, Burrows NP, Roberts SO . Erythrodermic mycosis fungoides treated with total body irradiation and autologous bone marrow transplantation. Clin Exper Dermatol 1995; 20: 73–75.

    Article  CAS  Google Scholar 

  22. Ferra C, Servitje O, Petriz L, Estrach T, Martí R, Limón A et al. Autologous haematopoietic progenitor transplantation in advanced mycosis fungoides. Br J Dermatol 1999; 140: 1188–1189.

    CAS  PubMed  Google Scholar 

  23. Gabriel IH, Olavarria E, Jones RR, Whittaker SJ, Chaidos A, Apperley JF . Graft versus lymphoma effect after early relapse following reduced-intensity sibling stem cell transplantation for relapsed cytotoxic variant of mycosis fungoides. Bone Marrow Transplant 2007; 40: 401–403.

    Article  CAS  PubMed  Google Scholar 

  24. Olavarria E, Child F, Woolford A, Whittaker SJ, Davis JG, McDonald C et al. T-cell depletion and autologous stem cell transplantation in the management of tumour stage mycosis fungoides with peripheral blood involvement. Br J Haematol 2001; 114: 624–631.

    Article  CAS  Google Scholar 

  25. Russell-Jones R, Child F, Olavarria E, Whittaker SJ, Spittle M, Apperley JF . Autologous peripheral blood stem cell transplantation in tumor-stage mycosis fungoides: predictors of disease-free survival. Ann NY Acad Sci 2001; 941: 147–154.

    Article  CAS  PubMed  Google Scholar 

  26. Ingen-Housz-Oro S, Bachéeles H, Verola O, Lebbé C, Marolleau JP, Hennequin C et al. High-dose therapy and autologous stem cell transplantation in relapsing cutaneous lymphoma. Bone Marrow Transplant 2004; 33: 629–634.

    Article  CAS  PubMed  Google Scholar 

  27. Koeppel MC, Stoppa AM, Resbeut M, Blaise D, Coignet M, Coulier L et al. Mycosis fungoides and allogeneic bone marrow transplantation. Acta Derm Venereol 1994; 74: 331–332.

    CAS  PubMed  Google Scholar 

  28. Burt RK, Guitart J, Traynor A, Link C, Rosen ST, Pandolfino T et al. Allogeneic hematopoietic stem cell transplantation for advanced mycosis fungoides: evidence of a graft-versus-tumor effect. Bone Marrow Transplant 2000; 25: 111–113.

    Article  CAS  Google Scholar 

  29. Guitart J, Wickless SC, Oyama Y, Kuzel TM, Rosen ST, Traynor A et al. Long-term remission after allogeneic hematopoietic stem cell transplantation for refractory cutaneous T-cell lymphoma. Arch Dermatol 2002; 138: 1359–1365.

    PubMed  Google Scholar 

  30. Massod N, Russell KJ, Olerud JE, Sabath DE, Sale GE, Doney KC et al. Induction of complete remission of advanced stage mycosis fungoides by allogeneic hematopoietic stem cell transplantation. J Am Acad Dermatol 2002; 47: 140–145.

    Article  Google Scholar 

  31. Molina A, Nademanee A, Arber DA, Forman SJ . Remission of refractory Sézary syndrome alter bone marrow transplantation from a matched unrelated donor. Biol Blood Marrow Transplant 1999; 5: 400–404.

    Article  CAS  PubMed  Google Scholar 

  32. Molina A, Zain J, Arber DA, Angelopolou M, O'Donnell M, Murata-Collins J et al. Durable clinical, cytogenetic, and molecular remissions after allogeneic hematopoietic cell transplantation for refractory Sezary syndrome and Mycosis Fungoides. J Clin Oncol 2005; 23: 6163–6171.

    Article  PubMed  Google Scholar 

  33. Carrié E, Buzyn A, Fraigat S, Hermine O, Bodemer C . Mycosis fongoide transformé chez un enfant: traitement par transplantation médullaire allogénique avec effect ‘graft-versus-lymphoma’. Ann Dermatol Venereol 2007; 134: 471–476.

    Article  PubMed  Google Scholar 

  34. Soligo D, Ibatici A, Berti E, Morando P, Longhi E, Venegoni L et al. Treatment of advanced mycosis fungoides by allogeneic stem-cell transplantation with a nonmyeloablative regimen. Bone Marrow Transplant 2003; 31: 663–666.

    Article  CAS  Google Scholar 

  35. Herbert KE, Spencer A, Grigg A, Ryan G, McCormack C, Prince HM . Graft-versus-lymphoma effect in refractory cutaneous T-cell lymphoma after reduced-intensity HLA-matched sibling allogeneic stem cell transplantation. Bone Marrow Transplant 2004; 34: 521–525.

    Article  CAS  Google Scholar 

  36. Onida F, Saporiti G, Berti E, Della Volpe A, Annaloro C, Usardi P et al. Reduced-intensity conditioning allogeneic haematopoietic stem cell transplantation in advanced mycosis fungoides and Sézary syndrome. Bone Marrow Transplant 2007; 39 (Suppl. 1): S40 (abstract O360).

    Google Scholar 

  37. Nishio M, Sawada K, Koizumi K, Tarumi T, Takano H, Endo T et al. Recurrence with histological transformation 40 days after autologous peripheral blood stem cell transplantation (APBSCT) for cutaneous CD30-negative large T cell lymphoma. Bone Marrow Transplant 1998; 22: 1211–1214.

    Article  CAS  PubMed  Google Scholar 

  38. Nishio M, Koizumi K, Endo T, Takashima H, Haseyama Y, Fujimoto K et al. Effective high-dose chemotherapy combined with CD34+-selected autologous peripheral blood stem cell transplantation in a patient with cutaneous CD30-negative large T-cell lymphoma. Bone Marrow Transplant 2000; 25: 1315–1317.

    Article  CAS  PubMed  Google Scholar 

  39. Koizumi K, Sawada K, Nishio M, Katagiri E, Fukae J, Fukada Y et al. Effective high-dose chemotherapy followed by autologous peripheral blood stem cell transplantation in a patient with the aggressive form of cytophagic histiocytic panniculitis. Bone Marrow Transplant 1997; 20: 171–173.

    Article  CAS  PubMed  Google Scholar 

  40. Hashimoto H, Sawada K, Koizumi K, Nishio N, Endo T, Takashima T et al. Effective CD34+-selected autologous peripheral blood stem cell transplantation in a patient with subcutaneous panniculitic T cell lymphoma (SPTCL) transformed into leukemia. Bone Marrow Transplant 1999; 24: 1369–1371.

    Article  CAS  PubMed  Google Scholar 

  41. Haycox CL, Back AL, Raugi GJ, Piepkorn M . Subcutaneous T-cell lymphoma treated with systemic chemotherapy, autologous stem cell support, and limb amputation. J Am Acad Dermatol 1997; 37: 832–835.

    Article  CAS  PubMed  Google Scholar 

  42. Fijnheer R, Sanders CJG, Canniga MR, de Weger RA, Verdonck LF . Complete remission of a radiochemotherapy-resistant cutaneous T-cell lymphoma with allogeneic non-myeloablative stem cell transplantation. Bone Marrow Transplant 2003; 32: 345–347.

    Article  CAS  Google Scholar 

  43. Pérez-Persona E, Mateos-Mazón JJ, López-Villar O, Arcos MJ, Encinas C, Graciani IF et al. Complete remission of subcutaneous panniculitic T-cell lymphoma alter allogeneic transplantation. Bone Marrow Transplant 2006; 38: 821–822.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Haematology, Institut Català d'Oncologia, Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain

    R F Duarte

  2. Department of Haematology, Asklepios-Klinik St Georg, Hamburg, Germany

    N Schmitz

  3. Department of Dermatology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain

    O Servitje

  4. Department of Haematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

    A Sureda

Authors
  1. R F Duarte
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. N Schmitz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. O Servitje
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A Sureda
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

on behalf of the Lymphoma Working Party of the EBMT

Corresponding author

Correspondence to R F Duarte.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Duarte, R., Schmitz, N., Servitje, O. et al. Haematopoietic stem cell transplantation for patients with primary cutaneous T-cell lymphoma. Bone Marrow Transplant 41, 597–604 (2008). https://doi.org/10.1038/sj.bmt.1705968

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1705968

Keywords

This article is cited by

Search

Advanced search

Quick links