Allogeneic blood or marrow transplant (alloBMT) with post-transplant cyclophosphamide (PTCy) is safe and well tolerated in patients with peripheral T-cell lymphoma (PTCL), but graft source appears to play a role in efficacy outcomes, according to findings published in Transplantation and Cellular Therapy.
Researchers observed improvements in overall survival (OS) and progression-free survival (PFS) with peripheral blood transplants vs bone marrow transplants. Patients who received peripheral blood also had a lower cumulative incidence of relapse.
In this retrospective analysis, researchers reviewed the records of patients with PTCL who had undergone alloBMT with nonmyeloablative conditioning. Graft-vs-host disease (GVHD) prophylaxis consisted of PTCy, mycophenolate mofetil, and tacrolimus or sirolimus.
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The researchers analyzed 65 patients with a median age of 59 years (range, 24 to 75). Multiple subtypes of PTCL were represented in the study population. Bone marrow was used as the graft source in 71% of patients, and peripheral blood was used in the other 29%.
The median follow-up was 2.8 years (range, 290 days to 14.2 years). The 2-year OS rate was 55%, and the 2-year PFS rate was 49%. The 1-year cumulative incidence of relapse was 25%, and the 1-year non-relapse mortality (NRM) rate was 12%.
Peripheral blood transplants were associated with better efficacy outcomes than were bone marrow transplants. The 2-year OS rate was 84% with peripheral blood and 46% with bone marrow. The 2-year PFS rates were 79% and 39%, respectively. The 1-year cumulative incidence of relapse was 5% and 33%, respectively. Rates of NRM and GVHD did not differ significantly by graft source.
Overall, there were 29 cases of GVHD. Two patients had grade 3-4 acute GVHD, and 3 had severe chronic GVHD.
“Based on our results, [peripheral blood] allografts in this setting are safe and may offer superior outcomes in PTCL,” the researchers wrote. They noted that a total body irradiation dose of 400 cGy used with most peripheral blood grafts may have contributed to these results.
Reference
Sterling CH, Hughes MS, Tsai HL, et al. Allogeneic blood or marrow transplantation with post-transplantation cyclophosphamide for peripheral T-cell lymphoma: The importance of graft source. Transplant Cell Ther. Published online December 19, 2022. doi:10.1016/j.jtct.2022.12.009
This article originally appeared on Oncology Nurse Advisor
