Outcomes Of Hematopoietic Stem Cell Transplantation For Peripheral T Cell Lymphoma

Objective:Peripheral T-cell lymphoma (PTCL) comprises a heterogeneous group of mature NK/T-cell tumors with a dismal prognosis. This study is in an attempt to understand the role and timing of hematopoietic stem cell transplantation (HSCT) in PTCL.Methods:The study analyzed outcomes of a consecutive case series of 48 patients who underwent HSCT for PTCL between the years 1993 and 2013. Forteen patients received autologous HSCT as consolidation therapy,12 patients received autologous HSCT as salvage therapy and 22 patients received allogeneic HSCT.Results:With a median follow-up of 30.8 months (range,2 to 174 months),3-yr overall survival (OS) and progression-free survival (PFS) of 14 patients who received autologous HSCT as consolidation therapy was 61.1% and 53.6%, respectively.1-yr relapse risk (RR) and non-relapse mortality (NRM) was 21.4% and 7.1%, respectively.3-yr RR and NRM was 30.4% and 16.1%, respectively. Nine of 12 patients who received autologous HSCT as salvage therapy did not achieved partial remission before HSCT. With a median follow-up of 26 months (range,4 to 171 months),2-yr OS and PFS was 50.0% and 25.0%, respectively. Eight patients relapsed or progressed after HSCT and died,7 of whom relapsed or progressed within 1 year after HSCT.1-yr RR was 58.3%. No cases of severe acute toxicity were observed in 26 patients who received autologous HSCT. Sixteen (72.7%) of 22 patients who received allogeneic HSCT were with active disease before HSCT. Five patients died within one month after HSCT. With a median follow-up of 41.7 months (range,1 to 118 months) for survival patients, 3-yr OS and PFS was 45.5% and 35.1%, respectively. One case of severe acute graft-versus-host disease (GVHD) and 2 of extensive chronic GVHD were observed.1-yr RR and NRM was 27.3% and 37.7%, respectively. Nine patients enjoyed long-term disease-free survival.Conclusion:Autologous HSCT is a feasible and effective option for the frontline consolidation therapy in patients with PTCL. Yet the relapse risk remains high after transplantation. Autologous HSCT is also suitable for chemosensitive patients with relapsed or refractory PTCL as salvage therapy. For chemoresistent patients, there can be long-term disease-free survival after allogeneic HSCT. The drawback of allogeneic HSCT is the morbidity and mortality. New strategy has to be developed to reduce the transplant-related toxicity.