Phase 2 trial of allogeneic hematopoietic cell transplantation in mature T- or NK-lymphomas

Allogeneic hematopoietic cell transplantation (HCT) is a potential cure for patients with peripheral T-/NK-cell lymphomas (PTCL), but its application is understudied. A phase 2 trial at the National Cancer Institute (Bethesda, MD) evaluated a unique reduced-intensity (RIC) transplantation platform in 31 patients with PTCL. One-year progression-free survival rate, the primary endpoint, was 53% (95% CI 29-72) on the RIC arm and 60% (25-83) on the modified-RIC arm. The 3-year overall survival rate was 61% (95% CI 42-76) with relapse estimated at 18% (6-34) at 3 years. Transplant-related mortality rate was 24% (95% CI 10-41) at 1 year; low at 11% (2-29) for patients aged ≤ 60 years but 56% (17-82) for patients aged > 60 years. There was no grade III or IV graft-versus-host disease, while chronic graft-versus-host disease was estimated at 23% (95% CI 10-38) at 2 years. The authors conclude that the study demonstrated a benefit regardless of pre-transplanation disease status, challenging the requirement of remission for HCT.