T-cell lymphomas are generally aggressive malignancies with poor prognosis. There are no standard treatment guidelines for T-cell lymphomas, and the timing of stem cell transplantation (SCT) is not well known. In this study, we investigated the outcomes of Taiwanese patients with T-cell lymphomas after SCT. We retrospectively analyzed 131 patients with T-cell lymphomas receiving SCT (autologous: 90, allogeneic: 41) from 2009 to 2014. More autologous SCT recipients were ALCL or in complete remission, and more allogeneic recipients had advanced disease. 56 patients who were sensitive to chemotherapy underwent SCT as upfront setting. The 2-year PFS and OS rates were 67.0 and 64.5%, respectively. Regarding disease status before transplantation, patients with CR1 had the best outcomes. Among different subtypes, patients with natural killer/T-cell lymphomas showed the worst outcomes, with 2-year OS rate of 23.5%. The OS rates for the other three major subtypes were as follows: 72.9% for ALCL; 75.0% for AITL; and 51.4% for PTCL-NOS. For more rare subtypes, such as ATLL and SPTCL, data from our study show that SCT can be beneficial. We concluded that upfront autologous SCT is feasible and effective for patients with low PIT, and disease status at transplant is the strong predictor of outcome.
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Anderson JR, Armitage JO, Weisen burger DD. Epidemiology of the non-Hodgkin’s lymphomas: distributions of the major subtypes differ by geographic locations. Ann Oncol. 1998;9:717–20.
Vose J, Armitage J, Weisenburger D. International T-Cell Lymphoma Project. International peripheral T-cell and natural killer/T-cell lymphoma study: pathology findings and clinical outcomes. J Clin Oncol. 2008;26:4124–30.
Taiwan Cancer Registry, 2008–2014
Schmitz N, Trümper L, Ziepert M, Nickelsen M, Ho AD, Metzner B, et al. Treatment and prognosis of mature T-cell and NK-cell lymphoma: an analysis of patients with T-cell lymphoma treated in studies of the German High-Grade Non-Hodgkin Lymphoma Study Group. Blood. 2010;116:3418–25.
Numata A, Miyamoto T, Ohno Y, Kamimura T, Kamezaki K, Tanimoto T, et al. Long-term outcomes of autologous PBSCT for peripheral T-cell lymphoma: retrospective analysis of the experience of the Fukuoka BMT group. Bone Marrow Transplant. 2010;45:311–6.
Ennishi D, Maeda Y, Fujii N, Kondo E, Shinagawa K, Ikeda K, et al. Allogeneic hematopoietic stem cell transplantation for advanced extranodal natural killer/T-cell lymphoma, nasal type. Leuk Lymphoma. 2011;52:1255–61.
Fukano R, Mori T, Kobayashi R, Mitsui T, Fujita N, Iwasaki F, et al. Haematopoietic stem cell transplantation for relapsed or refractory anaplastic large cell lymphoma: a study of children and adolescents in Japan. Br J Haematol. 2015;168:557–63.
Bacigalupo A, Ballen K, Rizzo D, Giralt S, Lazarus H, Ho V, et al. Defining the intensity of conditioning regimens: Working definitions. Biol Blood Marrow Transplant. 2009;15:1628–33.
Cheson BD, Horning SJ, Coiffier B, Shipp MA, Fisher RI, Connors JM, et al. Report of an international workshop to standardize response criteria for non-Hodgkin’s lymphomas. NCI Sponsored International Working Group. J Clin Oncol. 1999;17:1244–53.
Haioun C, Lepage E, Gisselbrecht C, Salles G, Coiffier B, Brice P, et al. Survival benefit of high-dose therapy in poor-risk aggressive non-Hodgkin’s lymphoma: final analysis of the prospective LNH87-2 protocol—a groupe d’Etude des lymphomes de l’Adulte study. J Clin Oncol. 2000;18:3025–30.
Rodríguez J, Caballero MD, Gutiérrez A, Marín J, Lahuerta JJ, Sureda A, et al. High-dose chemotherapy and autologous stem cell transplantation in peripheral T-cell lymphoma: the GEL-TAMO experience. Ann Oncol. 2003;14:1768–75.
Rodríguez J, Conde E, Gutiérrez A, Lahuerta JJ, Arranz R, Sureda A, et al. The adjusted International Prognostic Index and beta-2-microglobulin predict the outcome after autologous stem cell transplantation in relapsing/refractory peripheral T-cell lymphoma. Haematologica. 2007;92:1067–74.
Blystad AK, Enblad G, Kvaløy S, Berglund A, Delabie J, Holte H, et al. High-dose therapy with autologous stem cell transplantation in patients with peripheral T cell lymphomas. Bone Marrow Transplant. 2001;27:711–6.
Chen AI, McMillan A, Negrin RS, Horning SJ, Laport GG. Long-term results of autologous hematopoietic cell transplantation for peripheral T cell lymphoma: the Stanford experience. Biol Blood Marrow Transplant. 2008;14:741–7.
Smith SM, Burns LJ, van Besien K, Lerademacher J, He W, Fenske TS, et al. Hematopoietic cell transplantation for systemic mature T-cell non-Hodgkin lymphoma. J Clin Oncol. 2013;31:3100–9.
Gui L, Shi YK, He XH, Lei YH, Zhang HZ, Han XH, et al. High-dose therapy and autologous stem cell transplantation in peripheral T-cell lymphoma: treatment outcome and prognostic factor analysis. Int J Hematol. 2014;99:69–78.
Reimer P, Rüdiger T, Geissinger E, Weissinger F, Nerl C, Schmitz N, et al. Autologous stem-cell transplantation as first-line therapy in peripheral T-cell lymphomas: results of a prospective multicenter study. J Clin Oncol. 2009;27:106–13.
d’Amore F, Relander T, Lauritzsen GF, Jantunen E, Hagberg H, Anderson H, et al. Up-front autologous stem-cell transplantation in peripheral T-cell lymphoma: NLG-T-01. J Clin Oncol. 2012;30:3093–9.
Dodero A, Spina F, Narni F, Patriarca F, Cavattoni I, Benedetti F, et al. Allogeneic transplantation following a reduced-intensity conditioning regimen in relapsed/refractory peripheral T-cell lymphomas: long-term remissions and response to donor lymphocyte infusions support the role of a graft-versus-lymphoma effect. Leukemia. 2012;26:520–6.
Czajczynska A, Günther A, Repp R, Humpe A, Schub N, Raff T, et al. Allogeneic stem cell transplantation with BEAM and alemtuzumab conditioning immediately after remission induction has curative potential in advanced T-cell non-Hodgkin’s lymphoma. Biol Blood Marrow Transplant. 2013;19:1632–7.
Yang DH, Kim WS, Kim SJ, Bae SH, Kim SH, Kim IH, et al. Prognostic factors and clinical outcomes of high-dose chemotherapy followed by autologous stem cell transplantation in patients with peripheral T cell lymphoma, unspecified: complete remission at transplantation and the prognostic index of peripheral T cell lymphoma are the major factors predictive of outcome. Biol Blood Marrow Transplant. 2009;15:118–25.
Hosing C, Champlin RE. Stem-cell transplantation in T-cell non-Hodgkin’s lymphomas. Ann Oncol. 2011;22:1471–7.
Kanate AS, DiGilio A, Ahn KW, Al Malki M, Jacobsen E, Steinberg A et al. Allogeneic haematopoietic cell transplantation for extranodal natural killer/T-cell lymphoma, nasal type: a CIBMTR analysis. Br J Haematol. https://doi.org/10.1111/bjh.14879 2017.
Yamazaki H, Aoki K, Kondo T, Nishikori M, Kitano T, Hishizawa M. Outcome of allogeneic hematopoietic stem cell transplantation in cases of mature T/NK-cell neoplasms: a single-center retrospective analysis. Ann Hematol. 2017;96:323–6.
Bazarbachi A, Suarez F, Fields P, Hermine O. How I treat adult T-cell leukemia/lymphoma. Blood. 2011;118:1736–45.
Fuji S, Yamaguchi T, Inoue Y, Utsunomiya A, Moriuchi Y, Uchimaru K, et al. Development of a modified prognostic index for patients with aggressive adult T-cell leukemia-lymphoma aged 70 years or younger: possible risk-adapted management strategies including allogeneic transplantation. Haematologica. 2017;102:1258–65.
Fuji S, Inoue Y, Utsunomiya A, Moriuchi Y, Uchimaru K, Choi I, et al. Pretransplantation anti-CCR4 antibody mogamulizumab against adult T-cell leukemia/lymphoma is associated with significantly increased risks of severe and corticosteroid-refractory graft-versus-host disease, nonrelapse mortality, and overall mortality. J Clin Oncol. 2016;34:3426–33.
Alaibac M, Berti E, Pigozzi B, Chiarion V, Aversa S, Marino F, et al. High-dose chemotherapy with autologous blood stem cell transplantation for aggressive subcutaneous panniculitis-like T-cell lymphoma. J Am Acad Dermatol. 2005;52(5Suppl 1):S121–23.
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 after allogeneic transplantation. Bone Marrow Transplant. 2006;38:821–2.
Sakurai E, Satoh T, Akiko YA, Maesawa C, Tsunoda K, Endo M, et al. Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) with hemophagocytosis (HPS): successful treatment using high-dose chemotherapy (BFM-NHL & ALL-90) and autologous peripheral blood stem cell transplantation. J Clin Exp Hematop. 2013;53:135–40.
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The authors declare that they have no conflict of interest.
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Hsu, YT., Tsai, HJ., Chang, J.S. et al. Stem cell transplantation for T-cell lymphomas in Taiwan. Bone Marrow Transplant 53, 993–1000 (2018). https://doi.org/10.1038/s41409-018-0116-6
Decision analysis of up-front autologous hematopoietic stem cell transplantation in patients with peripheral T-cell lymphoma
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