Up‐front autologous hematopoietic stem cell transplantation after first complete remission improved prognosis of advanced extra‐nodal NKT cell lymphoma: A multicenter real‐world study in China

• Published in: European journal of haematology 2023-06, Vol.110 (6), p.680-687
• Main Authors: Gao, Honghao, Lin, Ningjing, Gu, Zhenyang, Zhao, Shihua, Wang, Xiaopei, Yuan, Shunzong, Song, Yuqin, Zhu, Jun, Huang, Wenrong, Liu, Weiping, Gao, Chunji
• Format: Article
• Language: English
• Subjects: advanced extra‐nodal NK/T‐cell lymphoma (ENKTL); Antineoplastic Combined Chemotherapy Protocols - adverse effects; Autografts; autologous hematopoietic stem cell transplantation (ASCT); Chemotherapy; Hematopoietic Stem Cell Transplantation - adverse effects; Hematopoietic stem cells; Humans; Lymphoma; Lymphoma, Extranodal NK-T-Cell; Lymphoma, T-Cell, Peripheral - etiology; Medical prognosis; Natural Killer T-Cells; Patients; Prognosis; Prospective Studies; Remission; Stem cell transplantation; Toxicity
• ISSN: 0902-4441; 1600-0609
• DOI: 10.1111/ejh.13950

Objectives The advanced extra‐nodal NK/T‐cell lymphoma (ENKTL) is highly aggressive and lacks effective treatment with a poor prognosis. This study aimed to investigate the effectiveness and safety of autologous hematopoietic stem cell transplantation (ASCT) in CR1. Methods Forty of 121 patients with advanced ENKTL from four Chinese hospitals between January 2006 to December 2021 who achieved first complete remission (CR1) and received at least 4 cycles chemotherapy, were enrolled for analysis. Twenty patients received ASCT as up‐front consolidation therapy (Group A), and 20 patients only received chemotherapy (Group B). Clinical features, treatment and follow‐up information were collected. Results With a median follow‐up of 27 months (range, 4–188 months), the 2‐year overall survival (OS) in Group A, 61% (95% CI 37%–85%), was better than that in Group B, 26% (95% CI 2%–50%), p = .018. The 2‐year progression‐free survival (PFS) was 56% (95% CI 32%–80%) in Group A, 26% (95% CI 2%–50%) in Group B, p = .026. III–IV grade hematological toxicity was the most common adverse event. No treatment‐related deaths were observed in both groups. Conclusion Up‐front ASCT could improve survival of advanced ENKTL patients in first complete remission, but need be confirmed by a prospective clinical trial.