Updates from the EBMT Lymphoma Working Group: outcomes after allo- and auto-SCT for T-cell lymphoma subtypes

A large retrospective study from the EBMT Lymphoma Working Group revealed different outcomes of autologous (auto-) versus allogeneic (allo-) stem cell transplantation (SCT) across major T-cell lymphoma subtypes. These results suggest that patients should be followed up according to their T-cell lymphoma entity after transplantation if feasible.

Dr Evgenii Shumilov (University of Münster, Germany) and colleagues aimed to investigate whether outcomes of allo- and auto-SCT differ between major T-cell lymphoma entities [1]. The current analysis included participants with peripheral T-cell lymphoma not otherwise specified (PTCL NOS; n=4,029), angioimmunoblastic T-cell lymphoma (AITL; n=2,838), and anaplastic lymphoma kinase rearranged (ALK)-positive (n=430) or ALK-negative (n=1,103) anaplastic large cell lymphoma (ALCL). Auto-SCT was performed in 7,099 and allo-SCT was conducted in 1,292 participants.

The 2-year overall survival rates of participants undergoing auto-SCT showed that participants with ALK-positive (85.3%) or ALK-negative ALCL (83.8%) lived significantly longer than those with PTCL NOS (66.0%) or AITL (68.9%; P<0.001; see Figure). For the group that underwent allo-SCT, only participants with ALK-positive ALCL had better 2-year survival rates (79.9%) compared with ALK-negative ALCL (63.3%), AITL (59.4%), or PTCL NOS (53.3%; P<0.001) cases. Although the survival rates of participants with 1 of the 3 latter entities were similar, the 4 investigated entities differed in 2-year relapse incidence rates (ALK-positive ALCL 23.2%; ALK-negative ALCL 36.2%; PTCL NOS 30.3%; AITL 13.4%) and non-relapse mortality rates (ALK-positive ALCL 11.6%; ALK-negative ALCL 14.4%; PTCL NOS 21.4%; AITL 30.0%).

Figure: Overall survival after auto-SCT according to lymphoma subtype [1]



AITL, angioimmunoblastic T-cell lymphoma; ALCL, anaplastic large cell lymphoma; allo-SCT, allogeneic stem cell transplantation; ALK, anaplastic lymphoma kinase rearranged; auto-SCT, autologous stem cell transplantation; OS, overall survival; PTCL NOS, peripheral T-cell lymphoma not otherwise specified.

“These outcomes indicate that patients with PTCL NOS, AITL, ALK-negative ALCL, and ALK-positive ALCL disease should be analysed separately after transplantation whenever possible,” concluded Dr Shumilov.

1. Shumilov E, et al. Outcomes of autologous and allogeneic stem cell transplantation for T-cell lymphoma: an updated analysis of the EBMT lymphoma working party. S245, EHA congress 2024, 13–16 June, Madrid, Spain.

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Posted on 12 August 202412 August 2024