1. Allogeneic stem-cell transplantation in patients with cutaneous lymphoma: updated results from a single institution.
- Author
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Hosing, C, Bassett, R, Dabaja, B, Talpur, R, Alousi, A, Ciurea, S, Popat, U, Qazilbash, M, Shpall, E, Oki, Y, Nieto, Y, Pinnix, C, Fanale, M, Maadani, F, Donato, M, Champlin, R, and Duvic, M
- Subjects
Sézary syndrome ,allogeneic stem-cell transplantation ,cutaneous T-cell lymphoma ,mycosis fungoides ,Adult ,Aged ,Disease-Free Survival ,Female ,Follow-Up Studies ,Hematopoietic Stem Cell Transplantation ,Humans ,Lymphoma ,T-Cell ,Cutaneous ,Male ,Middle Aged ,Prospective Studies ,Skin Neoplasms ,Transplantation ,Homologous ,Young Adult - Abstract
BACKGROUND: Cutaneous T-cell lymphomas (CTCLs) and its common variants mycosis fungoides (MF) and leukemic Sézary syndrome (SS) are rare extranodal non-Hodgkins lymphomas. Patients who present with advanced disease and large-cell transformation (LCT) are incurable with standard treatments. In this article, we report the largest single-center experience with allogeneic stem-cell transplantation (SCT) for advanced CTCL. PATIENTS AND METHODS: This is a prospective case series of 47 CTCL patients who underwent allogeneic SCT after failure of standard therapy between July 2001 and September 2013. The Kaplan-Meier method was used to estimate overall survival (OS) and progression-free survival (PFS) curves. The method of Fine and Gray was used to fit regression models to the same covariates for these cumulative incidence data. RESULTS: The Kaplan-Meier estimates of OS and PFS at 4 years were 51% and 26%, respectively. There was no statistical difference in the OS in patients who had MF alone, SS, MF with LCT, or SS with LCT. PFS at 4 years was superior in patients who had SS versus those who did not (52.4% versus 9.9%; P = 0.02). The cumulative incidences of grade 2-4 acute graft-versus-host disease (GVHD) and chronic GVHD were 40% and 28%, respectively. The cumulative nonrelapse mortality rate was 16.7% at 2 years. CONCLUSION: Allogeneic SCT may result in long-term remissions in a subset of patients with advanced CTCL. Although post-SCT relapse rates are high, many patients respond to immunomodulation and achieve durable remissions. CLINICALTRIALSGOV: NCT00506129.
- Published
- 2015