LY-05. Role of hematopoietic stem cell transplantation in the treatment of peripheral T-cell lymphomas: a multicenter experience
Elena E. Lepik1, Vladislav V. Kovalik1, Andrey V. Kozlov1, Evgenia S. Borzenkova1, Kirill V. Lepik1, Elena V. Kondakova1, Vadim V. Baykov1, Ivan S. Moiseev1, Tatiana V. Shneider2, Olga S. Uspenskaya2, Marina V. Demchenkova3, Vera V. Sergeevicheva4, Vadim M. Kemaikin5, Natalia B. Mikhailova1, Alexander D. Kulagin1
1 RM Gorbacheva Research Institute, Pavlov University, St. Petersburg, Russia
2 Leningrad Regional Clinical Hospital, St. Petersburg, Russia
3 Irkutsk Regional Cancer Center, Irkutsk, Russia
4 Federal State Budgetary Scientific Institution Research Institute of Fundamental and Clinical Immunology, Novosibirsk, Russia
5 National Research Oncology Center, Nur-Sultan, Kazakhstan
Dr. Elena E. Lepik, e-mail: email@example.com
Peripheral T-cell lymphomas (PTCL) are a group of rare, aggressive non-Hodgkin’s lymphomas originating from mature T-lymphocytes and characterized in most cases by refractory or relapsed disease course after standard therapies. We carried out retrospective a multicenter analysis of the treatment of patients with PTCL focusing on the transplantation methods of treatment.
Patients and methods
151 patients with PTCL were included who were treated in 5 clinical centers in Russia and Kazakhstan from 2005 to 2021. The most common histological variants were PTCL, NOS (n=51); anaplastic large cell lymphomas (ALCL), ALK+ (n=1); ALCL, ALK- (n=26); angioimmunoblastic T-cell lymphoma (n=24). The rest of the patients (n=29) had more rare forms of PTCL. The median age was 46 years (1-76). Of 151 patients, 94 (62%) had a primary refractory disease, 32 (21%) developed a relapse after the first line of therapy. 39 patients at different stages of treatment underwent autologous hematopoietic stem cell transplantation (auto-HSCT): 10 received auto-HSCT as a consolidation of the 1st line of therapy, 20 – after the 2nd line, 8 – after the 3rd line of therapy. At the time of auto-HSCT, all the patients were in complete (CR) or (PR) partial remission. Allo-HSCT was performed in 19 patients with a more aggressive. Allo-HSCT as a 1st transplant was performed in 14 patients. Allo-HSCT was performed in 5 patients with auto-HSCT failure.
77 patients were alive at the time of analysis. Median follow-up was 35 months (1-277). The median overall survival (OS) was not reached; the 3-year survival rate was 54%. The median progression-free survival (PFS) was 4 months, the 3-year PFS of the entire group of patients is 16%. Patients who failed HSCT had a worse prognosis (3-year OS 45%) compared to patients who underwent auto-HSCT (3-year OS 55%) or allo-HSCT (3-year OS 71%). 3-year PFS after auto-HSCT and allo-HSCT – 24% and 55%, respectively. It was revealed that patients who received auto-HSCT as the 1st line of therapy had better prognosis comparing to patients who received auto-HSCT in second and subsequent lines of therapy. We also obtained data that the patients who underwent allo-HSCT in PR or CR have an advantage over patients who underwent allo-HSCT, when stabilization or progression of the disease was achieved (3-year OS 84% vs 25%).
Our data provide additional evidence that allo- and auto-HSCT are effective treatments for patients with PTCL. If a response is achieved, 1st line auto-HSCT is the preferred clinical option in most PTCL types. Allo-HSCT, when performed in PR or PR in case of refractory or recurrent course of the disease was associated with better prognosis for PTCL patients.
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Peripheral T cell lymphoma, hematopoietic stem cell transplantation, autologous, allogeneic, efficiency.