Allogeneic Blood or Marrow Transplantation with Post-transplantation Cyclophosphamide for Peripheral T-cell Lymphoma: Importance of Graft Source

doi:10.21203/rs.3.rs-2007516/v1

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Allogeneic Blood or Marrow Transplantation with Post-transplantation Cyclophosphamide for Peripheral T-cell Lymphoma: Importance of Graft Source

https://doi.org/10.21203/rs.3.rs-2007516/v1

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published 31 Mar, 2023

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While allogeneic blood or marrow transplantation (alloBMT) is an effective therapy for peripheral T-cell lymphoma (PTCL), the optimal approach in this patient population remains to be determined. Here we review outcomes in 65 consecutive patients with PTCL who underwent alloBMT with non-myeloablative (NMA) conditioning and post-transplantation cyclophosphamide (PTCy) for graft-versus-host disease (GVHD) prophylaxis. The graft source was bone marrow (BM) in 46 patients (71%) and peripheral blood (PB) in 19 patients (29%); all patients in the BM cohort received 200 cGy TBI, and most in the PB cohort (15/19) received 400 cGy TBI. With a median follow up of 2.8 years (range, 290 days-14.2 years), the 2-year PFS for the entire cohort was 49% (95% confidence interval [CI] 38–64%), and the 2-year OS was 55% (95% CI 44–69%). Outcomes were significantly improved in those receiving PB, including 2-year PFS of 79% (95% CI 63–100%) vs. 39% (95% CI 27–56%), 2-year OS of 84% (95% CI 69–100%) vs. 46% (95% CI 33–63%), and 1-year cumulative incidence of (CuI) relapse of 5% (95% CI 0–16%) vs. 33% (95% CI 19–46%), with no difference in GVHD or non-relapse mortality (NRM).

Peripheral T-cell lymphoma (PTCL) is a rare and heterogeneous non-Hodgkin lymphoma (NHL) characterized by an aggressive clinical course and limited effective treatment options for most subsets. Historically, outcomes have been poor with a 5-year overall survival (OS) as low as 20–40%. ^1–4 Despite advances in our understanding of disease biology and the development of novel therapies with new molecular targets, ^5–8 there remains a substantial need for improvement, particularly in the relapsed/refractory (R/R) setting. ⁹

Allogeneic bone or marrow transplantation (alloBMT) is a potentially curative option, which is often reserved for R/R PTCL but may also be considered as front-line consolidation for certain histologic subtypes, such as hepatosplenic T-cell lymphoma (HSTCL) or adult T-cell leukemia/lymphoma (ATLL). ^10,11 With increased use of chimeric antigen receptor (CAR) T-cell therapy for diffuse large B-cell lymphoma, T-cell lymphomas are now the most common lymphomas to be treated with alloBMT in the United States. ¹² The benefit of alloBMT lies in its unique graft-versus-lymphoma (GVL) effect, ^13–15 driven primarily by an allogeneic immune reaction directed against major and minor histocompatibility antigens. ¹⁶ Although the benefit provided by the GVL effect was historically counterbalanced by the toxicity of graft-versus-host disease (GVHD), post-transplantation cyclophosphamide (PTCy) allows for safe and effective transplantation, ¹⁷ even when using mismatched donors. ¹⁸ It also appears to reduce severe GVHD while allowing mild GVHD and the associated antitumor activity. ¹⁹

While alloBMT is an effective therapy in PTCL, the preferred approach to alloBMT in this patient population remains to be determined. Here we review outcomes in 65 consecutive patients with PTCL who underwent alloBMT with non-myeloablative (NMA) conditioning and PTCy for GVHD prophylaxis.

Study Design

This retrospective analysis was approved by the Institutional Review Board of the Johns Hopkins Medical Institutions. We reviewed the charts of all adult patients aged 18 years or older who underwent alloBMT with NMA and PTCy for PTCL at The Sidney Kimmel Comprehensive Cancer Center between January 2004 and December 2020.

Conditioning and GVHD Prophylaxis

All patients received fludarabine, cyclophosphamide, and total body irradiation (TBI). Fludarabine was administered at 30 mg/m² IV daily for 5 days (day − 6 to day − 2) for a total dose of 150 mg/m². Cyclophosphamide was given as a 1- to 2- hour infusion at 14.5 mg/kg IV daily for 2 days (day − 6 to day − 5) for a total dose of 29 mg/kg. TBI was administered as a single dose of 200 or 400 cGy on day − 1. For GVHD prophylaxis, patients received PTCy, mycophenolate mofetil, and tacrolimus or sirolimus. PTCy was administered at 50 mg/kg IV per day on days + 3 and + 4. Mycophenolate mofetil was given from day + 5 to day + 35. Tacrolimus or sirolimus was given from day + 5 to day + 180 (before January 2018) or day + 60 (after January 2018).

Disease Status and Outcome Measures

The Lugano classification and response criteria outlined by Cheson et al. was used for initial staging and determination of disease status at the time of alloBMT.²⁰ Neutrophil recovery was defined as an absolute neutrophil count (ANC) of ≥ 0.5 cells/µL for 3 consecutive days. Platelet recovery was defined as a platelet count greater than 20 x 10³/µL for 7 days without transfusion. Donor chimerism was assessed on days 30 and 60 after alloBMT by polymerase chain reaction analysis of variable number of nucleotide tandem repeats unique to donors or recipients on total peripheral blood and isolated CD3⁺ T cells. Full donor chimerism was defined as ≥ 95% donor CD3⁺ T cells detected in peripheral blood. Patients alive 60 days after alloBMT were included in engraftment and chimerism analyses. Acute GVHD (aGVHD) was graded according to the Glucksberg criteria.²¹ Chronic GVHD (cGVHD) was assessed according to the National Institutes of Health consensus criteria.²² Progression-free survival (PFS) was defined from the date of BMT to the date of relapse or death. Individuals who remained alive and without relapse were censored on the date of last follow up for PFS. Overall survival (OS) was defined from the date of BMT to the date of death from any cause.

Statistical Analysis

The Kaplan-Meier method was applied to summarize OS and PFS. When estimating the cumulative incidence (CuI) of relapse, non-relapse mortality (NRM) was a competing event, and vice versa. Univariate analysis for OS and PFS was conducted using Cox proportional hazards model, and Fine-Gray model in the presence of competing risks for relapse and NRM. All statistical analyses were conducted using R 4.1.0 (R Foundation for Statistical Computing, Vienna, Austria).

Patient Characteristics

Sixty-five consecutive patients were identified. The median age was 59 years (range, 24–75 years) with 32 patients (49%) age 60 years or older (Table 1). Fifty-five patients (85%) were diagnosed with stage III-IV disease. PTCL not otherwise specified (PTCL-NOS, n = 24) and ALK-negative anaplastic large cell lymphoma (ALCL, n = 14) were the most common subsets. Five patients (8%) had undergone prior autologous BMT (autoBMT). Eleven patients were in first complete remission (CR1, 17%) at the time of alloBMT; the remaining patients were either in first partial remission (PR1, n = 5) or received salvage therapy to at least a PR prior to alloBMT.

Table 1

Patient characteristics (n = 65)
Gender
Male	44 (68%)
Female	21 (32%)
Histology
AITL	7 (11%)
ALK-negative ALCL	14 (22%)
ATLL	3 (5%)
EATL	6 (9%)
ENKTCL	1 (2%)
HSTCL	4 (6%)
PTCL-NOS	24 (37%)
PTCL-TFH	1 (2%)
SPTCL	2 (3%)
T-PLL	3 (5%)
Disease status prior to BMT
CR	43 (66%)
PR	22 (34%)
Source
BM	46 (71%)
PB	19 (29%)
Match
Full	10 (15%)
Haploidentical	48 (74%)
Mismatched unrelated	7 (11%)
Abbreviations: AITL (angioimmunoblastic T-cell lymphoma), ALCL (anaplastic large cell lymphoma), ATLL (adult T-cell leukemia/lymphoma), EATCL (enteropathy-associated T-cell lymphoma), ENKTCL (extra-nodal NK/T-cell lymphoma), HSTCL (hepatosplenic T-cell lymphoma), PTCL-NOS (peripheral T-cell lymphoma not otherwise specified), PTCL-TFH (peripheral T-cell lymphoma with T-follicular helper cell phenotype), SPTCL (subcutaneous panniculitis-like T-cell lymphoma), T-PLL (T-cell prolymphocytic leukemia), BMT (blood or marrow transplantation), CR (complete remission), PR (partial remission), BM (bone marrow), PB (peripheral blood)

Transplant characteristics

Forty-eight patients underwent alloBMT from haploidentical related donors (haplo, 74%), 10 from fully matched donors (full, 15%), and 7 from mismatched unrelated donors (mMUD, 11%). The first 50 patients received 200 cGy of TBI, and the graft source was BM in the first 46 patients (71%). Because of relatively high relapse rates, in 2018 we began using G-CSF stimulated PB allografts and increased TBI from 200 to 400 cGy, more consistent with reduced intensity conditioning. ²³ The remaining 19 patients (29%) received PB allografts, 15 of which also received 400 cGy TBI.

Outcomes

Sixty of 63 evaluable patients (95%) engrafted, including all patients who received PB. Median neutrophil recovery occurred on day 18 (range, 11–47 days). Median platelet recovery occurred on day 21 (range, 11–57 days). Full donor chimerism was achieved in 50 patients (79%). With a median follow up of 2.8 years (range, 290 days-14.2 years), the 2-year PFS for the entire cohort was 49% (95% confidence interval [CI] 38–64%), and the 2-year OS was 55% (95% CI 44–69%). The CuI relapse and NRM at 1 year was 25% (95% CI 14–35%) and 12% (95% CI 4–20%), respectively (Fig. 1). Among 29 cases of GVHD (45%), only 2 were grade 3–4 aGVHD (3%) and 3 were severe cGVHD (5%). The 14 cases of NRM were due to infection (n = 8), cardiovascular disease (n = 3), renal failure (n = 2), and therapy-related myeloid neoplasm (n = 1). Two patients underwent second alloBMT for relapsed disease; both later died without relapse. Among 23 patients alive and without relapse, histology subtypes included angioimmunoblastic T-cell lymphoma (AITL, n = 2), ALK-negative ALCL (n = 8), ATLL (n = 1), HSTCL (n = 1), PTCL-NOS (n = 9), subcutaneous panniculitis-like T-cell lymphoma (SPTCL, n = 1), and T-cell prolymphocytic leukemia (T-PLL, n = 1). Univariate analysis including age, histology, mMUD, PB graft source, 1st remission, and CR prior to alloBMT revealed only PB graft source and CR prior to alloBMT as predictors of survival, relapse, or NRM. Outcomes were significantly improved in those receiving PB compared to BM, including 2-year PFS of 79% (95% CI 63–100%) vs. 39% (95% CI 27–56%), 2-year OS of 84% (95% CI 69–100%) vs. 46% (95% CI 33–63%), and 1-year CuI relapse of 5% (95% CI 0–16%) vs. 33% (95% CI 19–46%), with no difference in GVHD or NRM (Table 2). Full results from univariate analysis can be found in the Supplementary Information.

Table 2

Outcomes by Source
	Median [IQR] Follow-Up	2-yr PFS	2-yr OS	1-yr CuI relapse	1-yr CuI NRM
PB	2.2 [1.4–6.2] year (n = 14)	79% (95% CI 63–100%)	84% (95% CI 69–100%)	5% (95% CI 0–16%)	16% (95% CI 0–33%)
BM	4.7 [3.2–10.3] year (n = 11)	39% (95% CI 27–56%)	46% (95% CI 33–63%)	33% (95% CI 19–46%)	11% (95% CI 2–20%)
p-value	0.005	0.035	0.041	0.012	0.600
Abbreviations: IQR (inter-quartile range among surviving patients), PFS (progression-free survival), OS (overall survival), CuI (cumulative incidence of), NRM (non-relapse mortality), PB (peripheral blood), BM (bone marrow)

We previously published our institutional experience of 44 patients with PTCL who underwent alloBMT between January 1994 and June 2011, including 20 patients who received myeloablative conditioning (MAC) and 24 NMA/RIC. ²⁴ Here we evaluate outcomes in 65 consecutive patients with PTCL who underwent alloBMT after January 2004 using NMA conditioning and PTCy for GVHD prophylaxis, an increasingly common approach to alloBMT as outlined below.

Multiple registry^25–28 and other retrospective studies ^15,29−33 have assessed alloBMT outcomes in PTCL, but its optimal application in this challenging patient population remains to be determined. At the 2020 American Society of Hematology (ASH) Meeting, Mehta-Shah et al. presented what was the largest retrospective study to date at that time with 508 patients with mature T-cell lymphoma who underwent alloBMT, 323 of which received NMA/RIC, demonstrating 2-year OS and PFS of 59.1% and 45.8%, respectively. ³³ More recently, Hamadani et al. performed a collaborative study between the European Society for Blood and Marrow Transplantation (EBMT) and the Center for International Blood and Marrow Transplant Research (CIBMTR) reviewing outcomes in 1942 patients with PTCL-NOS, AITL, and ALCL who underwent alloBMT with most receiving RIC; donors were haplo (n = 237), matched sibling (n = 911), matched unrelated with in vivo T-cell depletion (n = 468), and matched unrelated without in vivo T-cell depletion (n = 326). Their results showed a 3-year OS of 59–64% and 3-year PFS of 48–52%, with similar survival outcomes among the 4 cohorts. ²⁸

PTCy-based GVHD prophylaxis is a well-established method for expanding the donor pool without compromising safety in patients with lymphoma undergoing alloBMT,^24,34−37 though published accounts in PTCL are often limited to haplo donors. Castagna et al. reported outcomes in 68 patients with PTCL who underwent alloBMT with NMA/RIC, including 29 patients from haplo donors who received PTCy for GVHD prophylaxis and 39 patients from matched sibling (n = 20) or unrelated donors (n = 19) who received cyclosporine A; graft source was PB in 85% of cases. Their results showed a 4-year OS and 4-year PFS of 75% and 70%, respectively, with 2-year cumulative incidence of relapse of 21% and 2-year NRM of 9%. They also noted lower aGVHD and 4-year NRM in alloBMT from related donors;³² this finding was not seen our study, where 10 patients underwent alloBMT from unrelated donors (7 mMUD, 3 full) without increased GVHD and no instances of NRM. However, it is worth noting all patients in our study received PTCy, rather than the haploidentical donors only. PTCy-based GVHD prophylaxis was also used in patients who underwent alloBMT from a haplo donor (n = 237) in the previously mentioned study by Hamadani et al. ²⁸

The most striking finding in our study is the difference in outcomes based on graft source; compared to BM, PB allografts were associated with significantly improved PFS and OS, lower relapse, and no significant difference in NRM or GVHD. In a meta-analysis involving 9 randomized controlled trials (RCTs) assessing alloBMT graft source for hematologic malignancies in adults, PB was associated with faster engraftment but increased risk of GVHD compared to BM. ³⁸ A Lymphoma Working Party (LWP)-EBMT study of 474 lymphoma patients (including 88 with PTCL) who underwent alloBMT using haplo donors, PTCy, and either RIC (77%) or MAC (23%) showed similar results with improved engraftment but increased GVHD. ³⁹ PB allografts have also been associated with reduced risk of relapse and improved survival in patients with Hodgkin lymphoma who underwent alloBMT with RIC. ⁴⁰ While some studies have found no association between graft source and survival outcomes in PTCL, ²⁸ source may be influenced by conditioning regimen, ⁴¹ donor selection, ²⁸ and histology/disease characteristics. ²⁶ In our study, all patients received NMA conditioning with PTCy, regardless of histology or other clinical features. Based on our results, PB allografts in this setting are safe and may offer superior outcomes in PTCL. Since the use of PB allografts was accompanied by increased TBI dosing to 400 cGy in our study (15 of 19 patients), we cannot assume the benefits seen in this cohort were due to graft source alone; increased TBI dosing may have contributed as well. Our study also demonstrated improved PFS and OS in those patients in CR vs. PR prior to alloBMT, a finding consistent with prior studies of PTCL patients. ^15,26,28,33

One of the limitations of our study is the smaller sample size, which limited more extensive statistical analysis. The median follow up among survivors was also significantly shorter in those receiving PB (2.2 years) vs. BM (4.7 years) after alloBMT. While there were no differences in histology, disease status prior to alloBMT, or prior therapies between these 2 cohorts, longer follow up and a larger cohort size are needed to evaluate outcome differences with adjustment of potential confounders.

In conclusion, alloBMT using NMA conditioning with PTCy for GVHD prophylaxis is well-tolerated in patients with PTCL. Our preliminary data suggest increasing TBI dose to 400 cGy and using PB allografts may offer improved disease control and better survival outcomes, though longer follow up and additional studies are needed.

AUTHOR CONTRIBUTIONS

CHS and MSH performed data extraction. CHS, HLT, and RV analyzed the data. KY, NWJ, RJJ, RFA, JBM, PHI, AD, LJS, SP, SAA, TJ, AA, CAH, and CBG contributed to data interpretation and provided feedback on report.

Ellin F, Landström J, Jerkeman M, Relander T. Real-world data on prognostic factors and treatment in peripheral T-cell lymphomas: A study from the swedish lymphoma registry. Blood. 2014;124(10):1570–1577.
Janikova A, Chloupkova R, Campr V, et al. First-line therapy for T cell lymphomas: A retrospective population-based analysis of 906 T cell lymphoma patients. Ann Hematol. 2019;98(8):1961–1972.
Lansigan F, Horwitz SM, Pinter-Brown LC, et al. Outcomes for relapsed and refractory peripheral T-cell lymphoma patients after front-line therapy from the COMPLETE registry. Acta Haematol. 2020;143(1):40–50.
Bellei M, Foss FM, Shustov AR, et al. The outcome of peripheral T-cell lymphoma patients failing first-line therapy: A report from the prospective, international T-cell project. Haematologica. 2018;103(7):1191–1197.
Laribi K, Alani M, Truong C, Baugier de Materre A. Recent advances in the treatment of peripheral T-cell lymphoma. Oncologist. 2018;23(9):1039–1053.
Mulvey E, Ruan J. Biomarker-driven management strategies for peripheral T cell lymphoma. J Hematol Oncol. 2020;13(1):59-z.
Ma H, Marchi E, O'Connor OA. The peripheral T-cell lymphomas: An unusual path to cure. Lancet Haematol. 2020;7(10):e765-e771.
Horwitz S, O'Connor OA, Pro B, et al. The ECHELON-2 trial: 5-year results of a randomized, phase III study of brentuximab vedotin with chemotherapy for CD30-positive peripheral T-cell lymphoma. Ann Oncol. 2022;33(3):288–298.
Ma H, Cheng B, Falchi L, et al. Survival benefit in patients with peripheral T-cell lymphomas after treatments with novel therapies and clinical trials. Hematol Oncol. 2020;38(1):51–58.
d'Amore F, Gaulard P, Trümper L, et al. Peripheral T-cell lymphomas: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2015;26 Suppl 5:108.
Kharfan-Dabaja MA, Kumar A, Ayala E, et al. Clinical practice recommendations on indication and timing of hematopoietic cell transplantation in mature T cell and NK/T cell lymphomas: An international collaborative effort on behalf of the guidelines committee of the american society for blood and marrow transplantation. Biol Blood Marrow Transplant. 2017;23(11):1826–1838.
Shah NN, Hamadani M. Is there still a role for allogeneic transplantation in the management of lymphoma? J Clin Oncol. 2021;39(5):487–498.
Jones RJ, Ambinder RF, Piantadosi S, Santos GW. Evidence of a graft-versus-lymphoma effect associated with allogeneic bone marrow transplantation. Blood. 1991;77(3):649–653.
Corradini P, Dodero A, Zallio F, et al. Graft-versus-lymphoma effect in relapsed peripheral T-cell non-hodgkin's lymphomas after reduced-intensity conditioning followed by allogeneic transplantation of hematopoietic cells. J Clin Oncol. 2004;22(11):2172–2176.
Dodero A, Spina F, Narni F, et al. Allogeneic transplantation following a reduced-intensity conditioning regimen in relapsed/refractory peripheral T-cell lymphomas: Long-term remissions and response to donor lymphocyte infusions support the role of a graft-versus-lymphoma effect. Leukemia. 2012;26(3):520–526.
Warren EH, Deeg HJ. Dissecting graft-versus-leukemia from graft-versus-host-disease using novel strategies. Tissue Antigens. 2013;81(4):183–193.
Luznik L, O'Donnell PV, Symons HJ, et al. HLA-haploidentical bone marrow transplantation for hematologic malignancies using nonmyeloablative conditioning and high-dose, posttransplantation cyclophosphamide. Biol Blood Marrow Transplant. 2008;14(6):641–650.
Ghosh N, Karmali R, Rocha V, et al. Reduced-intensity transplantation for lymphomas using haploidentical related donors versus HLA-matched sibling donors: A center for international blood and marrow transplant research analysis. J Clin Oncol. 2016;34(26):3141–3149.
McCurdy SR, Kanakry CG, Tsai HL, et al. Development of grade II acute graft-versus-host disease is associated with improved survival after myeloablative HLA-matched bone marrow transplantation using single-agent post-transplant cyclophosphamide. Biol Blood Marrow Transplant. 2019;25(6):1128–1135.
Cheson BD, Fisher RI, Barrington SF, et al. Recommendations for initial evaluation, staging, and response assessment of hodgkin and non-hodgkin lymphoma: The lugano classification. J Clin Oncol. 2014;32(27):3059–3068.
Glucksberg H, Storb R, Fefer A, et al. Clinical manifestations of graft-versus-host disease in human recipients of marrow from HL-A-matched sibling donors. Transplantation. 1974;18(4):295–304.
Filipovich AH, Weisdorf D, Pavletic S, et al. National institutes of health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. diagnosis and staging working group report. Biol Blood Marrow Transplant. 2005;11(12):945–956.
Bacigalupo A, Ballen K, Rizzo D, et al. Defining the intensity of conditioning regimens: Working definitions. Biol Blood Marrow Transplant. 2009;15(12):1628–1633.
Kanakry JA, Kasamon YL, Gocke CD, et al. Outcomes of related donor HLA-identical or HLA-haploidentical allogeneic blood or marrow transplantation for peripheral T cell lymphoma. Biol Blood Marrow Transplant. 2013;19(4):602–606.
Smith SM, Burns LJ, van Besien K, et al. Hematopoietic cell transplantation for systemic mature T-cell non-hodgkin lymphoma. J Clin Oncol. 2013;31(25):3100–3109.
Le Gouill S, Milpied N, Buzyn A, et al. Graft-versus-lymphoma effect for aggressive T-cell lymphomas in adults: A study by the société francaise de greffe de moëlle et de thérapie cellulaire. J Clin Oncol. 2008;26(14):2264–2271.
Mamez AC, Dupont A, Blaise D, et al. Allogeneic stem cell transplantation for peripheral T cell lymphomas: A retrospective study in 285 patients from the société francophone de greffe de moelle et de thérapie cellulaire (SFGM-TC). J Hematol Oncol. 2020;13(1):56–4.
Hamadani M, Ngoya M, Sureda A, et al. Outcome of allogeneic transplantation for mature T-cell lymphomas: Impact of donor source and disease characteristics. Blood Adv. 2022;6(3):920–930.
Delioukina M, Zain J, Palmer JM, Tsai N, Thomas S, Forman S. Reduced-intensity allogeneic hematopoietic cell transplantation using fludarabine-melphalan conditioning for treatment of mature T-cell lymphomas. Bone Marrow Transplant. 2012;47(1):65–72.
Goldberg JD, Chou JF, Horwitz S, et al. Long-term survival in patients with peripheral T-cell non-hodgkin lymphomas after allogeneic hematopoietic stem cell transplant. Leuk Lymphoma. 2012;53(6):1124–1129.
Jacobsen ED, Kim HT, Ho VT, et al. A large single-center experience with allogeneic stem-cell transplantation for peripheral T-cell non-hodgkin lymphoma and advanced mycosis fungoides/sezary syndrome. Ann Oncol. 2011;22(7):1608–1613.
Castagna L, Pagliardini T, Bramanti S, et al. Allogeneic stem cell transplantation in poor prognosis peripheral T-cell lymphoma: The impact of different donor type on outcome. Bone Marrow Transplant. 2021;56(4):883–889.
Mehta-Shah N, Kommalapati A, Teja S, et al. Successful treatment of mature T-cell lymphoma with allogeneic stem cell transplantation: The largest multicenter retrospective analysis. Blood. 2020;136(Supplement 1):35–36. https://doi.org/10.1182/blood-2020-138542.
Castagna L, Bramanti S, Devillier R, et al. Haploidentical transplantation with post-infusion cyclophosphamide in advanced hodgkin lymphoma. Bone Marrow Transplant. 2017;52(5):683–688.
Dietrich S, Finel H, Martinez C, et al. Post-transplant cyclophosphamide-based haplo-identical transplantation as alternative to matched sibling or unrelated donor transplantation for non-hodgkin lymphoma: A registry study by the european society for blood and marrow transplantation. Leukemia. 2016;30(10):2086–2089.
Martínez C, Gayoso J, Canals C, et al. Post-transplantation cyclophosphamide-based haploidentical transplantation as alternative to matched sibling or unrelated donor transplantation for hodgkin lymphoma: A registry study of the lymphoma working party of the european society for blood and marrow transplantation. J Clin Oncol. 2017;35(30):3425–3432.
Dreger P, Sureda A, Ahn KW, et al. PTCy-based haploidentical vs matched related or unrelated donor reduced-intensity conditioning transplant for DLBCL. Blood Adv. 2019;3(3):360–369.
Holtick U, Albrecht M, Chemnitz JM, et al. Bone marrow versus peripheral blood allogeneic haematopoietic stem cell transplantation for haematological malignancies in adults. Cochrane Database Syst Rev. 2014;(4):CD010189. doi(4):CD010189.
Bazarbachi A, Boumendil A, Finel H, et al. Influence of donor type, stem cell source and conditioning on outcomes after haploidentical transplant for lymphoma - a LWP-EBMT study. Br J Haematol. 2020;188(5):745–756.
Marcais A, Porcher R, Robin M, et al. Impact of disease status and stem cell source on the results of reduced intensity conditioning transplant for hodgkin's lymphoma: A retrospective study from the french society of bone marrow transplantation and cellular therapy (SFGM-TC). Haematologica. 2013;98(9):1467–1475.
Savani M, Ahn KW, Chen Y, et al. Impact of conditioning regimen intensity on the outcomes of peripheral T-cell lymphoma, anaplastic large cell lymphoma and angioimmunoblastic T-cell lymphoma patients undergoing allogeneic transplant. Br J Haematol. 2022;197(2):212–222.

The authors have declared there is NO conflict of interest to disclose.

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Allogeneic Blood or Marrow Transplantation with Post-transplantation Cyclophosphamide for Peripheral T-cell Lymphoma: Importance of Graft Source

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Journal Publication

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Abstract

Figures

Introduction

Methods

Study Design

Conditioning and GVHD Prophylaxis

Disease Status and Outcome Measures

Statistical Analysis

Results

Patient Characteristics

Transplant characteristics

Outcomes

Discussion

Declarations

AUTHOR CONTRIBUTIONS

References

Additional Declarations

Supplementary Files

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