Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Correspondence
  • Published:

Allogeneic haematopoietic stem cell transplantation in advanced cutaneous T-cell lymphomas offers curative potential

Bone Marrow Transplantation (2025)Cite this article

Subjects

Access through your institution
Buy or subscribe

Mycosis Fungoides (MF) and Sezary syndrome (SS) are subtypes of cutaneous T-cell lymphoma (CTCL). Advanced-stage MF/SS is associated with poor prognosis, with a median survival of less than four years, dropping to 13 months for patients with extensive nodal involvement (stage IVA2) [1]. A quarter of MF patients present with advanced-stage disease, while SS is classified as advanced-stage by definition. One-third of early-stage MF cases eventually progress to advanced disease. Primary cutaneous CD30+ anaplastic large cell lymphoma (ALCL), another CTCL subtype, generally has better prognosis and responds well to localized radiotherapy or brentuximab vedotin (BV) for widespread lesions. However, some ALCL cases are aggressive, and patients with relapsed systemic disease may benefit from allogeneic haematopoietic-stem-cell-transplantation (allo-HSCT) [2].

Advanced-stage CTCL typically presents in the seventh decade, twice as frequently in males. There is an unmet need for effective, durable treatments in advanced-stage CTCL. Current therapies are predominantly palliative, focusing on reducing tumour burden, delaying disease progression, and preserving quality of life. Studies suggest most treatments do not positively modify the disease course and early use of chemotherapy is associated with poorer outcomes [3]. Therapeutic responses are typically partial and short-lived (<1 year). For patients achieving a complete or near-complete response, reduced intensity conditioning (RIC) allo-HSCT is used, aiming to harness the graft-versus-lymphoma effect to achieve durable remissions and possible cure.

This is a preview of subscription content, access via your institution

Access options

Access through your institution

Buy this article

  • Purchase on SpringerLink
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Data availability

The datasets generated during the current study are available from the corresponding author on reasonable request.

References

  1. Brunner PM, Jonak C, Knobler R. Recent advances in understanding and managing cutaneous T-cell lymphomas. F1000Res. 2020;9:331. https://doi.org/10.12688/f1000research.21922.1

    Article  CAS  Google Scholar 

  2. Sarfraz H, Gentille C, Ensor J, Wang L, Wong S, Ketcham MS, et al. Primary cutaneous anaplastic large‐cell lymphoma: a review of the SEER database from 2005 to 2016. Clin Exp Derm. 2021;46:1420–6. https://doi.org/10.1111/ced.14777

    Article  CAS  PubMed  Google Scholar 

  3. Quaglino P, Maule M, Prince HM, Porcu P, Horwitz S, Duvic M, et al. Global patterns of care in advanced stage mycosis fungoides/Sezary syndrome: a multicenter retrospective follow-up study from the Cutaneous Lymphoma International Consortium. Ann Oncol. 2017;28:2517–25. https://doi.org/10.1093/annonc/mdx352

    Article  CAS  PubMed  Google Scholar 

  4. Latzka J, Assaf C, Bagot M, Cozzio A, Dummer R, Guenova E, et al. EORTC consensus recommendations for the treatment of mycosis fungoides/Sézary syndrome – Update 2023. Eur J Cancer. 2023;195:113343. https://doi.org/10.1016/j.ejca.2023.113343

    Article  PubMed  Google Scholar 

  5. Weng WK, Arai S, Rezvani A, Johnston L, Lowsky R, Miklos D, et al. Nonmyeloablative allogeneic transplantation achieves clinical and molecular remission in cutaneous T-cell lymphoma. Blood Adv. 2020;4:4474–82. https://doi.org/10.1182/bloodadvances.2020001627

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Scarisbrick JJ, Prince HM, Vermeer MH, Quaglino P, Horwitz S, Porcu P, et al. Cutaneous Lymphoma International Consortium Study of Outcome in Advanced Stages of Mycosis Fungoides and Sézary Syndrome: Effect of Specific Prognostic Markers on Survival and Development of a Prognostic Model. JCO. 2015;33:3766–73. https://doi.org/10.1200/JCO.2015.61.7142

    Article  CAS  Google Scholar 

  7. Johnson WT, Mukherji R, Kartan S, Nikbakht N, Porcu P, Alpdogan O. Allogeneic hematopoietic stem cell transplantation in advanced stage mycosis fungoides and Sézary syndrome: a concise review. Chin Clin Oncol. 2019;8:12–12. https://doi.org/10.21037/cco.2018.10.03

    Article  PubMed  Google Scholar 

  8. Scarisbrick J, Quaglino P, Whittaker S A New Prognostic Index (CLIPI) for Advanced Cutaneous Lymphoma Enables Patient Risk Stratification. Blood. In press 2025 May https://doi.org/10.1182/blood.2025029628

  9. Iqbal M, Reljic T, Ayala E, Sher T, Murthy H, Roy V, et al. Efficacy of allogeneic hematopoietic cell transplantation in cutaneous T cell lymphoma: results of a systematic review and meta-analysis. Biol Blood Marrow Transplant. 2020;26:76–82. https://doi.org/10.1016/j.bbmt.2019.08.019

    Article  PubMed  Google Scholar 

  10. Kim YH, Bagot M, Pinter-Brown L, Rook AH, Porcu P, Horwitz SM, et al. Mogamulizumab versus vorinostat in previously treated cutaneous T-cell lymphoma (MAVORIC): an international, open-label, randomised, controlled phase 3 trial. Lancet Oncol. 2018;19:1192–204. https://doi.org/10.1016/S1470-2045(18)30379-6

    Article  CAS  PubMed  Google Scholar 

  11. Duarte RF, Canals C, Onida F, Gabriel IH, Arranz R, Arcese W, et al. Allogeneic hematopoietic cell transplantation for patients with Mycosis Fungoides and Sézary Syndrome: A retrospective analysis of the lymphoma working party of the European Group for Blood and Marrow Transplantation. JCO. 2010;28:4492–9. https://doi.org/10.1200/JCO.2010.29.3241

    Article  Google Scholar 

  12. Lechowicz MJ, Lazarus HM, Carreras J, Laport GG, Cutler CS, Wiernik PH, et al. Allogeneic hematopoietic cell transplantation for mycosis fungoides and Sezary syndrome. Bone Marrow Transplant. 2014;49:1360–5. https://doi.org/10.1038/bmt.2014.161

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Devillier R, Fürst S, El-Cheikh J, Castagna L, Harbi S, Granata A, et al. Antithymocyte Globulin in reduced-intensity conditioning regimen allows a high disease-free survival exempt of long-term chronic graft-versus-host disease. Biol Blood Marrow Transplant. 2014;20:370–4. https://doi.org/10.1016/j.bbmt.2013.11.030

    Article  CAS  PubMed  Google Scholar 

  14. Duvic M, Donato M, Dabaja B, Richmond H, Singh L, Wei W, et al. Total skin electron beam and non-myeloablative allogeneic hematopoietic stem-cell transplantation in Advanced Mycosis Fungoides and Sézary Syndrome. JCO. 2010;28:2365–72. https://doi.org/10.1200/JCO.2009.25.8301

    Article  Google Scholar 

  15. Morris SL, Thomas BR, Palanicawandar R, Whittaker S, Child F, Wain M, et al. Long term outcomes of nonmyeloablative allogeneic stem cell transplantation with TSEB TLI and ATG for Mycosis Fungoides and Sezary Syndrome. Bone Marrow Transplant. 2024;59:874–9. https://doi.org/10.1038/s41409-024-02236-z

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

    Agni Hatzakis, Bernard D. Maybury, Sridhar Chaganti, Andrea Stevens, Bethanie Rooke, Elizabeth Peterknecht, Farida Shah, Usha Alluri, Duncan J. Murray & Julia J. Scarisbrick

Authors
  1. Agni Hatzakis
    View author publications

    Search author on:PubMed Google Scholar

  2. Bernard D. Maybury
    View author publications

    Search author on:PubMed Google Scholar

  3. Sridhar Chaganti
    View author publications

    Search author on:PubMed Google Scholar

  4. Andrea Stevens
    View author publications

    Search author on:PubMed Google Scholar

  5. Bethanie Rooke
    View author publications

    Search author on:PubMed Google Scholar

  6. Elizabeth Peterknecht
    View author publications

    Search author on:PubMed Google Scholar

  7. Farida Shah
    View author publications

    Search author on:PubMed Google Scholar

  8. Usha Alluri
    View author publications

    Search author on:PubMed Google Scholar

  9. Duncan J. Murray
    View author publications

    Search author on:PubMed Google Scholar

  10. Julia J. Scarisbrick
    View author publications

    Search author on:PubMed Google Scholar

Contributions

Bernard Maybury, Julia Scarisbrick, Sridhar Chaganti, Andrea Stevens, Bethanie Rooke, Elizabeth Peterknecht, Farida Shah, Usha Alluri, Duncan J Murray all helped with writing and editing the manuscript.

Corresponding author

Correspondence to Agni Hatzakis.

Ethics declarations

Ethics approval and consent to participate

This work was performed as part of a registered audit in allo-BMT for CTCL at Queen Elizabeth Hospital University Hospital Birmingham in accordance with relevant guidelines and regulations. Informed consent was obtained from all participates.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hatzakis, A., Maybury, B.D., Chaganti, S. et al. Allogeneic haematopoietic stem cell transplantation in advanced cutaneous T-cell lymphomas offers curative potential. Bone Marrow Transplant (2025). https://doi.org/10.1038/s41409-025-02683-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1038/s41409-025-02683-2

Search

Advanced search

Quick links