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LYMPHOMA

Autologous or allogeneic hematopoietic cell transplantation for relapsed or refractory PTCL-NOS or AITL

Leukemia volume 36, pages 1361–1370 (2022)Cite this article

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Abstract

Fit patients with peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS) and angioimmunoblastic T-cell lymphoma (AITL) in relapsed or refractory (R/R) disease status often receive salvage chemotherapy followed by autologous hematopoietic stem cell transplantation (autoHCT) or allogeneic HCT (alloHCT). However, there is no consensus on the type of HCT that should be applied for such patients. Herein, we retrospectively evaluated the survival outcome of 760 adult R/R PTCL-NOS or AITL patients who underwent the first HCT. Among them, 318 relapsed after first remission (REL) and 442 were refractory to the primary therapy (PIF). The 4-year overall survival (OS) of autoHCT and alloHCT was 50 and 50% for REL patients, and 52 and 49% for PIF patients, respectively. In the multivariable analysis, alloHCT tended to be associated with better progression-free survival (PFS) in REL (hazard ratio [HR] 0.74; 95% confidence interval [CI]: 0.53–1.03), and significantly better PFS in PIF (HR 0.64; 95% CI: 0.46–0.88) compared with autoHCT. The subgroup analysis with propensity-score matching showed that alloHCT was associated with better OS for REL-sensitive and PIF-nonremission disease. This study suggested that the advantage of alloHCT for R/R PTCL-NOS or AITL is different, depending on the disease status at HCT.

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Fig. 1: Comparison of overall survival (OS) and relapse/progression-free survival (PFS) between auto- and alloHCT.
Fig. 2: Comparison of relapse/progression incidence (RI) and nonrelapse/progression mortality (NRM) between auto- and alloHCT.
Fig. 3: Overall survival comparing alloHCT with autoHCT based on patients’ characteristics in REL group (A) and PIF group (B).
Fig. 4: Comparison of survival between auto- and alloHCT in the propensity-score-matched cohort.

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Acknowledgements

The authors greatly appreciate the physicians and data managers of the JSTCT centers for providing excellent patient care and reporting clinical data to the TRUMP. We also thank the members of The Japanese Data Center for HCT for their dedicated data management. We thank H. Nikki March, PhD, from Edanz (https://jp.edanz.com/ac) for language editing a draft of this paper.

Funding

This work was supported in part by the Practical Research Project for Allergic Diseases and Immunology (Research Technology of Medical Transplantation) from the Japan Agency for Medical Research and Development, AMED (19ek0510023h) (to Y.A.), Grants-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (20J14747), Jichi Medical University Graduate Student Research Award 2021, and Japan Leukemia Research Award (to K. Kameda).

Author information

Authors and Affiliations

  1. Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan

    Kazuaki Kameda & Shinichi Kako

  2. Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan

    Sung-Won Kim & Takahiro Fukuda

  3. Division of Cancer Information and Control, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan

    Yoshiaki Usui

  4. Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan

    Koji Kato

  5. Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, Japan

    Naoyuki Uchida

  6. Department of Hematology, Nagano Red Cross Hospital, Nagano, Japan

    Hikaru Kobayashi

  7. Department of Hematology and Oncology, Shimane Prefectural Central Hospital, Izumo, Japan

    Toshio Wakayama

  8. Department of Hematology, Chiba University Hospital, Chiba, Japan

    Emiko Sakaida

  9. Division of Clinical Oncology and Hematology, The Jikei University School of Medicine, Tokyo, Japan

    Shingo Yano

  10. Department of Hematology, Japanese Red Cross Osaka Hospital, Osaka, Japan

    Kazunori Imada

  11. Division of Hematology, Nephrology and Rheumatology, Akita University Hospital, Akita, Japan

    Miho Nara

  12. Division of Hematology and Stem Cell Transplantation, Shizuoka Cancer Center, Shizuoka, Japan

    Takashi Ikeda

  13. Department of Hematology, Japan Community Health Care Organization Kyoto Kuramaguchi Medical Center, Kyoto, Japan

    Shin-ichi Fuchida

  14. Department of Hematology, Osaka International Cancer Institute, Osaka, Japan

    Jun Ishikawa

  15. Department of Hematology, Sumitomo Hospital, Osaka, Japan

    Hiroyuki Sugahara

  16. Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Junya Kanda

  17. Preparation Department, Japanese Red Cross Kinki Block Blood Center, Osaka, Japan

    Takafumi Kimura

  18. Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan

    Tatsuo Ichinohe

  19. Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan

    Yoshiko Atsuta

  20. Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, Japan

    Yoshiko Atsuta

  21. Department of Hematology, Kawasaki Medical School, Kurashiki, Japan

    Eisei Kondo

Authors
  1. Kazuaki Kameda
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  2. Shinichi Kako
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  3. Sung-Won Kim
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  4. Yoshiaki Usui
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  6. Takahiro Fukuda
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  7. Naoyuki Uchida
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  8. Hikaru Kobayashi
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  9. Toshio Wakayama
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  10. Emiko Sakaida
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  11. Shingo Yano
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  12. Kazunori Imada
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  13. Miho Nara
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  17. Hiroyuki Sugahara
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  19. Takafumi Kimura
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  21. Yoshiko Atsuta
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  22. Eisei Kondo
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Contributions

K. Kameda, S.K., S.-W.K. and E.K. designed the study. K. Kameda performed analyses and wrote the first draft of the paper. S.K., S.-W.K., Y.U., and K. Kato reviewed and revised the paper. T.F., N.U., H.K., T.W., E.S., S.Y., K. I., M.N., T.I., S.F., J.I., and H.S. are the leading physicians at each institution that made significant contributions to provision of data to the TRUMP. J.K., T.K., T.I., and Y.A. collected and assembled data. All authors discussed the results, interpreted the data, and approved the final version of the paper.

Corresponding author

Correspondence to Kazuaki Kameda.

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Competing interests

Conflicts of interest disclosure: K. Kato is a consultant for, and has received research funding from AbbVie, Chugai Pharmaceutical Co., Ltd., Daiichi Sankyo, Eisai, and Novartis; is a consultant for AstraZeneca; has received honoraria and research funding from Bristol-Myers Squibb, Kyowa Kirin, and Ono; is a consultant and has received honoraria and research funding from Celgene, Janssen; has received honoraria from Sumitomo Dainippon Pharma Co., Ltd., NSD, Mundi, outside the submitted work. K.I. has received honoraria from Chugai Pharmaceutical Co., Ltd., Kyowa Hakko Kirin Co., Ltd., Novartis Pharma K.K., Celgene Co., Ltd., Bristol-Myers Squibb K.K., Takeda Pharmaceutical Co. Ltd., Nippon Shinyaku Co., Ltd., Otuka Pharmaceutical Co. Ltd., Astellas Pharma Inc., and Sumitomo Dainippon Pharma Co., Ltd., outside the submitted work. S.F. has received honoraria from Takeda Pharmaceutical Co., Ltd., Ono Pharmaceutical Co., Ltd., Janssen Pharmaceutical K.K., Sanofi, Bristol-Myers Squibb Co., Ltd., and Celgene Co., Ltd., outside the submitted work. T.I. reports research funding from Astellas Pharma, Chugai Pharmaceutical Co., CSL Behring, Eisai Co., FUJIFILM Wako Chemicals., Kyowa Kirin Co., Ono Pharmaceutical Co., Pfizer, Nippon Shinyaku Co., Abbvie, Otsuka Pharmaceutical Co., Repertoire Genesis Inc., Sumitomo Dainippon Pharma Co., Taiho Pharmaceutical Co., Takara Bio Inc., Takeda Pharmaceutical Co., and Zenyaku Kogyo Co., honoraria from Bristol-Myers Squibb, Celgene, Janssen Pharmaceutical K.K., Kyowa Kirin Co., Takeda Pharmaceutical Co., CSL Behring, Astellas Pharma, Eisai Co., Novartis, FUJIFILM Wako Chemicals., Nippon Shinyaku Co., and Repertoire Genesis Inc., outside the submitted work. E.K. has received honoraria from Takeda Pharmaceutical Co and Sumitomo Dainippon Pharma Co, outside the submitted work. The remaining authors declare no competing financial interests.

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Prior presentation Partially presented in an oral presentation at the EHA2021 Virtual Congress, June 9–17, 2021 (abstract S244).

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Kameda, K., Kako, S., Kim, SW. et al. Autologous or allogeneic hematopoietic cell transplantation for relapsed or refractory PTCL-NOS or AITL. Leukemia 36, 1361–1370 (2022). https://doi.org/10.1038/s41375-022-01545-w

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