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Allogeneic stem cell transplantation for patients with relapsed or refractory T-cell lymphoma: efficacy of lymphoma-directed conditioning against advanced disease

Bone Marrow Transplantation volume 54, pages 877–884 (2019)Cite this article

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Abstract

Salvage chemotherapy induces disease remissions in patients with relapsed or refractory (r/r) T-cell lymphomas, but fails to provide lasting tumor control. We analyzed the outcome after peripheral blood stem and bone marrow transplantation (PBSCT, n = 80; BMT, n = 4) from matched related (MRD, n = 22) or matched and unmatched unrelated donors (MUD and MMD, n = 53 and n = 9, respectively) following conditioning with fludarabine, busulfan, and cyclophosphamide (FBC) for 84 consecutive patients with r/r T-cell malignancies. At start of conditioning LDH was elevated in 50% of cases, and residual tumor (PD, SD, PR) was detectable in 84% of patients. In total, 38% (95% CI 33–44) of the patients were alive and disease-free after a median observation time of 14.5 (range 1.8 to 114) months. Univariate and multivariate analyses identified low ECOG status, as well as occurrence of acute GvHD as favorable factors for outcome. Lymphoma-directed conditioning with fludarabin, busulfan and cyclophosphamid (FBC-12), and allogeneic stem cell transplantation resulted in long-term survival for a proportion of patients with r/r peripheral T-cell lymphoma, including those with PR and SD only after salvage therapy.

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Author contributions

Conception and design: GW, BG, NS, LT. Collection and assembly of data: GW, BG, GH, CW. Patient care: all coauthors. Data analysis and interpretation: GW, BG, NS, LT. Paper writing: GW, BG, NS, LT, MP. Final approval of paper: all coauthors.

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Author notes

  1. Michael Pfreundschuh is deceased

Authors and Affiliations

  1. University Medicine Göttingen, Göttingen, Germany

    Gerald Wulf, Justin Hasenkamp & Wolfram Jung

  2. University Hospital Giessen und Marburg, Marburg, Germany

    Christian Wilhelm

  3. Westpfalz-Klinikum, Kaiserslautern, Germany

    Gerhard Held

  4. Onkologie Lerchenfeld, Hamburg, Germany

    Maike Nickelsen

  5. Institut für Medizinische Statistik, Göttingen, Germany

    Andreas Leha

  6. Universitätsklinikum des Saarlands, Homburg, Germany

    Michael Pfreundschuh

  7. Universitätsklinikum Münster, Münster, Germany

    Norbert Schmitz

  8. HELIOS Klinikum Berlin-Buch, Berlin, Germany

    Bertram Glass

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  1. Gerald Wulf
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Correspondence to Gerald Wulf.

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Wulf, G., Hasenkamp, J., Jung, W. et al. Allogeneic stem cell transplantation for patients with relapsed or refractory T-cell lymphoma: efficacy of lymphoma-directed conditioning against advanced disease. Bone Marrow Transplant 54, 877–884 (2019). https://doi.org/10.1038/s41409-018-0360-9

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