C Hosing1, R Bassett2, B Dabaja3, R Talpur4, A Alousi5, S Ciurea5, U Popat5, M Qazilbash5, E J Shpall5, Y Oki6, Y Nieto5, C Pinnix3, M Fanale6, F Maadani5, M Donato7, R Champlin5, M Duvic4. 1. Department of Stem Cell Transplantation and Cellular Therapy cmhosing@mdanderson.org. 2. Department of Biostatistics. 3. Department of Radiation Oncology. 4. Department of Dermatology. 5. Department of Stem Cell Transplantation and Cellular Therapy. 6. Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston. 7. Department of Blood and Marrow Transplantation, John Theurer Cancer Center, Hackensack, USA.
Abstract
BACKGROUND: Cutaneous T-cell lymphomas (CTCLs) and its common variants mycosis fungoides (MF) and leukemic Sézary syndrome (SS) are rare extranodal non-Hodgkin's 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.
BACKGROUND: Cutaneous T-cell lymphomas (CTCLs) and its common variants mycosis fungoides (MF) and leukemic Sézary syndrome (SS) are rare extranodal non-Hodgkin's 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.
Authors: Alexandra H Filipovich; Daniel Weisdorf; Steven Pavletic; Gerard Socie; John R Wingard; Stephanie J Lee; Paul Martin; Jason Chien; Donna Przepiorka; Daniel Couriel; Edward W Cowen; Patricia Dinndorf; Ann Farrell; Robert Hartzman; Jean Henslee-Downey; David Jacobsohn; George McDonald; Barbara Mittleman; J Douglas Rizzo; Michael Robinson; Mark Schubert; Kirk Schultz; Howard Shulman; Maria Turner; Georgia Vogelsang; Mary E D Flowers Journal: Biol Blood Marrow Transplant Date: 2005-12 Impact factor: 5.742
Authors: R D Bigler; P Crilley; B Micaily; L W Brady; D Topolsky; S Bulova; E C Vonderheid; I Brodsky Journal: Bone Marrow Transplant Date: 1991-02 Impact factor: 5.483
Authors: Rafael F Duarte; Carmen Canals; Francesco Onida; Ian H Gabriel; Reyes Arranz; William Arcese; Augustin Ferrant; Guido Kobbe; Franco Narni; Giorgio Lambertenghi Deliliers; Eduardo Olavarría; Norbert Schmitz; Anna Sureda Journal: J Clin Oncol Date: 2010-08-09 Impact factor: 44.544
Authors: D Przepiorka; D Weisdorf; P Martin; H G Klingemann; P Beatty; J Hows; E D Thomas Journal: Bone Marrow Transplant Date: 1995-06 Impact factor: 5.483
Authors: Julia Dai; Timothy H Almazan; Eric K Hong; Michael S Khodadoust; Sally Arai; Wen-Kai Weng; Youn H Kim Journal: JAMA Dermatol Date: 2018-06-01 Impact factor: 10.282
Authors: Silvana Novelli; Anna Monter; M Pilar García-Muret; Rodrigo Martino; Javier Briones; Jorge Sierra Journal: Int J Hematol Date: 2019-07-17 Impact factor: 2.490
Authors: Wen-Kai Weng; Sally Arai; Andrew Rezvani; Laura Johnston; Robert Lowsky; David Miklos; Judith Shizuru; Lori Muffly; Everett Meyer; Robert S Negrin; Erica Wang; Timothy Almazan; Lynn Million; Michael Khodadoust; Shufeng Li; Richard T Hoppe; Youn H Kim Journal: Blood Adv Date: 2020-09-22
Authors: Caitlin M Brumfiel; Meera H Patel; Pranav Puri; Jake Besch-Stokes; Scott Lester; William G Rule; Nandita Khera; Jason C Sluzevich; David J DiCaudo; Nneka Comfere; N Nora Bennani; Allison C Rosenthal; Mark R Pittelkow; Aaron R Mangold Journal: Curr Treat Options Oncol Date: 2021-09-27
Authors: Xochiquetzal U Martinez; Cosimo Di Raimondo; Farah R Abdulla; Jasmine Zain; Steven T Rosen; Christiane Querfeld Journal: Best Pract Res Clin Haematol Date: 2019-06-06 Impact factor: 3.670