Allogeneic Hematopoietic Stem Cell Transplantation for T Cell Lymphomas: Improved Results Overtime

• Published in: Blood 2019-11, Vol.134 (Supplement_1), p.3325-3325
• Main Authors: Novelli, Silvana, Bento, Leyre, García-Cadenas, Irene, Prieto, Laura, Corral, Lucía López, Gutierrez Garcia, Gonzalo, Hernani, Rafael, Pérez Martínez, Ariadna, Sierra, Jorge, Solano, Carlos, Bastos-Oreiro, Mariana, Dorado, Nieves, Rodríguez-Torres, Nancy, Rodríguez, Guillermo, Piñana Sanchez, Jose Luis, Montoro Gómez, Juan, Herrera Puente, Pilar, Luna, Alejandro, Sanchez Ortega, Isabel, Martin Calvo, Carmen, López-Godino, Oriana, Heras, Inmaculada, Zanabili, Joud, Palomo Moraleda, María Del Pilar, Parody, Rocio, Moraleda, Jose Maria, Yáñez, Lucrecia, Gutiérrez, Antonio, Zudaire, Teresa, Cordoba, Raul, Varela, Rosario, Ferra, Christelle M, Martinez-Lopez, Joaquin, García-Torres, Estefania, Caballero, Dolores
• Format: Article
• Language: English
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood-2019-126507

Allogeneic hematopoietic stem cell transplantation (alloSCT) is the only curative strategy for relapsed/refractory T cell lymphoma (T-NHL). In the past ten years, there have been several improvements in conditioning regimens and graft versus host disease prophylaxis (GVHD), which have contributed to lower transplant-related mortality (TRM). Also, selective and low toxicity therapies, might improve response quality in some T-NHL Recently, haploidentical stem cell transplantation (Haplo) with post-transplant cyclophosphamide is a new option for those patients who do not have an HLA-identical sibling or a suitable unrelated donor, but also it has shortened the time for urgent cases. This study analyzes overall outcomes of 211 consecutive patients diagnosed with T-NHL who received an alloSCT from 1995 to 2018 in GELTAMO/GETH centers. Previous therapies (chemotherapies and autologous stem cell transplantation) and baseline diagnostic parameters were recorded. RESULTS The median age at alloSCT was 47 years (range, 17-69). (see table 1). Forty-nine (23%) had primary extranodal disease. Disease status pre alloSCT was available in 202 patientes: 54% were in complete response (CR), 30% in partial response (PR) and 16% with stable/progressive disease (PD). Since 2013 BV was used as a bridge therapy in ≥ 3rd line in 25 patients with CD30+ tumor expression, it was effective in 20 (CR 68% (n=17), PR 12% (n=3) PD 16% (n=4), not assessed in 1 case). The use of BV was not associated with a better response probability pre alloSCT compared with other regimens used after third line and it did not impact on post alloSCT outcomes. Reduced intensity conditioning (RIC) was the most frequent (76%, n=156). (see table 2) GVHD prophylaxis were Methotrexate + CsaA or Tacrolimus (n=72, 35,8%), sirolimus-tacrolimus (n=37; 18,4%), Cy-post based (n=44, 21,9%; used in Haplo setting n= 29). The median follow-up of all cohort was 22.5 months (range, 0-280). The two year overall survival (OS) and disease free survival (DFS) were 60% (CI95%, 53-67%) and 76.7% (CI95%, 69.3-82.5%) (Figure 1A) We observed a significant improvement in alloSCT outcomes since 2011 (OS