EBMT 2018 | Retrospective analysis of the role of allo-SCT in PTCL

A lymphoma working party session took place at the 44^th European Society for Blood and Marrow Transplantation (EBMT) annual meeting on 20 March 2018. Abstract WP7-6 won the Jian-jian Luan award for the best abstract in the topic of Lymphoma. The abstract presented by Anne-Claire Mamez, Hôpitaux Universitaires de Genève, Department of Hematology, Geneva on the role of allogeneic stem cell transplant (allo-SCT) use in patients with peripheral T-cell lymphoma (PTCL).

The retrospective analysis assessed PTCL patients who had allo-SCT between 2006 and 2014 using the Francophone Society of bone marrow transplantation and cellular therapy (SFGM)-TC database. Two-hundred and eighty-four patients were included in the study with a median age of 50 years (range, 16–69) were transplanted at a median of 12.6 months after diagnosis.

Patients received transplant as either first-line treatment (29%), after 2 lines (36%) and after ≥3 lines (35%). The speaker noted that 94% of patients had a Karnofsky performance status of above 80%. The donors for allo-SCT were either matched-related (45%), matched-unrelated (36%) or alternative (19%). Conditioning regimens given included: reduced intensity conditioning (RIC) n = 147, myeloablative (MAC) n = 106 and non-myeloablative (NMA) n = 27.

Key Findings

• Median follow-up = 33 months
• 1-year overall survival (OS) = 68% (95% CI, 0.62–0.7) and event-free survival (EFS) = 63% (95% CI, 0.57–0.69)
• 2-year OS = 64% (95% CI, 0.58–0.7) and EFS = 59% (95% CI, 0.53–0.65)
• 4-year OS = 57% (95% CI, 0.5–0.63)
• In a subgroup analysis of 30 patients with progressive disease, 50% achieved a complete response with a 2-year OS of 51%
• Median time to relapse = 94 days
• Non-relapse mortality = 22% (1-year) and 24% (2-year)
  • Deaths occurred due to relapse (35%), infection (27%) and graft-versus-host-disease (GvHD; 22%)
• Grade II-IV GvHD was observed in 31% of patients
• Chronic GvHD occurred in 34%

The speaker concluded that according to the study findings at long term follow-up, grade ≥3 GvHD and low Karnofsky scores negatively impacted OS. Additionally, the conditioning regimen did not significantly influence OS.