Retrospective analysis of hematopoietic stem cell transplant in patients with hepatosplenic T-cell lymphoma

There is no established standard therapy for hepatosplenic T-cell lymphoma. A retrospective analysis by the EBMT Lymphoma Working Party aimed to better define the roles of allogeneic and autologous hematopoietic stem cell transplantation (alloHCT/ autoHCT) in patients with hepatosplenic T-cell lymphoma. The analysis included 94 patients who underwent alloHSCT and27 patients who underwent autoHSCT. The majority of patients were in complete remission when they underwent transplantation: 41 (44%) of 93 patients with remission data before alloHSCT and 20 (74%) of patients with remission data before autoHSCT. With a median follow-up of 4.5 years (IQR 3.4-5.6) after alloHSCT, 3-year progression-free survival rate was 50.5% (95% CI 39.4-60.5) and 3-year overall survival rate was 55.0% (43.9-64.8), 3-year nonrelapse mortality rate was 11.7% (5.9-19.5) and 3-year relapse incidence was 37.9% (27.6-48.1). With a median follow-up of 5.0 years (IQR 4.3-6.6) after autoHSCT, 3-year PFS rate was 38.9% (95% CI 17.5-60.0) and 3-year OS rate was 63.5% (41.3-79.3), whereas 3-year NRM rate was 11.1% (1.7-30.7) and 3-year relapse incidence was 50.0% (24.9-70.8). The authors conclude that alloHSCT is an effective and potentially curative treatment option for patients with hepatosplenic T-cell lymphoma; autoHSCT is frequently followed by relapse and might be only recommended for patients with a complete response and ineligible for alloHSCT.