Published in:
01-06-2018 | Original Article
Allogeneic hematopoietic stem cell transplantation in Primary Cutaneous T Cell Lymphoma
Authors:
Laura Cudillo, Raffaella Cerretti, Alessandra Picardi, Benedetta Mariotti, Gottardo De Angelis, Maria Cantonetti, Massimiliano Postorino, Eleonora Ceresoli, Giovanna De Santis, Daniela Nasso, Francesco Pisani, Enrico Scala, Fabio Di Piazza, Alessandro Lanti, William Arcese for the Rome Transplant Network
Published in:
Annals of Hematology
|
Issue 6/2018
Login to get access
Abstract
In our retrospective study, 16 patients affected by advanced cutaneous T cell lymphoma (CTCL) underwent allogeneic hematopoietic stem cell transplantation (HSCT). Two patients (12.5%) were in complete remission (CR), nine (56.3%) in partial remission (PR), and five (31.2%) with active disease. The patients were transplanted from an HLA-identical (n = 7) from a mismatched (n = 1) or haploidentical (n = 1) sibling, from matched unrelated donor (n = 5), or from a single cord blood unit (n = 2). Conditioning regimen was standard myeloablative in 6 patients and at reduced intensity in 10. Seven patients died from non relapse mortality (NRM) and four patients relapsed or progressed, three of them achieved a second CR after donor lymphocyte infusion (DLI) or chemotherapy plus DLI. To date, with a median follow-up of 76 months (range 6–130), nine patients are alive, eight in CR, and one with active disease. Overall survival (OS) and disease-free survival (DFS) at 1 and 10 years are 61% (95% CI 40–91%) and 54% (95% CI 33–86%), 40% (95% CI 22–74%), and 34% (95% CI 16–68%), respectively. The time from diagnosis to transplant seems to influence negatively both OS (log-rank p < 0.04) and DFS (log-rank p < 0.05). Our results confirm on a long follow-up that CTCL appears particularly susceptible to the graft versus lymphoma (GVL) effect, so that allogeneic HSCT represents a possibility of cure for advanced CTCL. The timing of HSCT in the clinical course of disease remains an open issue.