Myeloablative Haploidentical Transplant as an Alternative to Matched Sibling Transplant for Peripheral T-Cell Lymphomas

• Published in: Cell transplantation Vol. 30; p. 963689721999615
• Main Authors: Zhenyang, Gu, Nainong, Li, Xiaoxiong, Wu, Maihong, Wang, Xiaorui, Fu, Zhao, Wang, Hanyun, Ren, Yuhang, Li, Xiaofan, Li, Yamei, Wu, Yao, Liu, Mingzhi, Zhang, Yini, Wang, Daihong, Liu, Yujun, Dong, Liangding, Hu, Wenrong, Huang
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 2021; Sage Publications Ltd; SAGE Publishing
• Subjects: Antilymphocyte serum; B-cell lymphoma; Globulins; Graft versus host disease; Graft-versus-host reaction; Histocompatibility antigen HLA; Lymphocytes B; Lymphocytes T; Lymphoma; Multivariate analysis; Original; Prophylaxis; Stem cell transplantation; T-cell lymphoma; Thymocytes; Transplants & implants; antithymocyte globulin; haploidentical donor; HLA-matched sibling donor; peripheral t-cell lymphoma; allo-HSCT
• ISSN: 0963-6897; 1555-3892
• DOI: 10.1177/0963689721999615

The number of HLA-haploidentical allogeneic hematopoietic stem-cell transplantation (Haplo-HSCT) is increasing. Comparative studies about Haplo-HSCT versus allo-HSCT with HLA-matched sibling donors (MSD-HSCT) have been tried in leukemias and B-cell lymphomas. Few studies were reported in Peripheral T-cell lymphomas (PTCLs). We performed a multicenter retrospective study about 52 patients with PTCLs undergoing Haplo-HSCT (n = 20) or MSD-HSCT (n = 32). All Haplo-HSCT recipients received antithymocyte globulin (ATG) based graft versus host disease (GVHD) prophylaxis. The median follow-up for all survivors was 38 months. The 100-day cumulative incidence of grade II to IV acute GVHD was similar (19% in the MSD-HSCT group versus 28% in the Haplo-HSCT group, P = 0.52). The 2-year cumulative incidence of chronic GVHD (limited and extensive) after Haplo-HSCT (30%) was also similar with that in the MSD-HSCT group (50%, P = 0.15). The 3-year relapse rates (33% vs 27%, P = 0.84) and non-relapse mortality (21% vs 22%, P = 0.78) did not differ between these two groups. There were also no differences in 3-year overall survival (OS) (48% vs 50%, P = 0.78) and progression-free survival (47% vs 51%, P = 0.95) between these two groups. On multivariate analysis, prognostic index for T-cell lymphoma (PIT) score (higher than 1: hazard ratio [HR], 4.0; P = 0.003) and disease status (stable or progression disease before HSCT: HR, 2.8; P = 0.03) were independent variables associated with worse OS. We concluded that ATG-based haplo-HSCT platform could work as an alternative to MSD-HSCT for patients with PTCLs.