Originally published as JCO Early Release 10.1200/JCO.2007.14.1366 on April 7 2008

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Graft-Versus-Lymphoma Effect for Aggressive T-Cell Lymphomas in Adults: A Study by the Société Française de Greffe de Moëlle et de Thérapie Cellulaire

Steven Le Gouill, Noel Milpied, Agnès Buzyn, Régis Peffault De Latour, Jean-Paul Vernant, Mohamad Mohty, Marie-Pierre Moles, Krimo Bouabdallah, Claude-Eric Bulabois, Jehan Dupuis, Bernard Rio, Nicole Gratecos, Ibrahim Yakoub-Agha, Michel Attal, Olivier Tournilhac, Didier Decaudin, Jean-Henry Bourhis, Didier Blaise, Christelle Volteau, Mauricette Michallet

From the Hematology Department; Service de la recherche bio-médicale, Centre Hospitalier Universitaire, Hôtel-Dieu, Nantes; Hematology Department, Centre Hospitalier Universitaire Haut-Lévêque, Pessac; Hematology Department, Hôpital Necker-Enfants malades; Service de greffe de moelle osseuse, Hôpital Saint-Louis; Hematology Department, Hôpital de la Pitié-Salpetrière; Hematology Department, Hôpital Hôtel-Dieu; Hematology Department, Institut Curie, AP-HP, Paris; Unité de transplantation et de thérapie cellulaire, Institut Paoli-calmette, Marseille; Hematology Department, Medical University, Angers; Hematology Department, Centre Hospitalier Universitaire, Grenoble; Hematology Department, Hôpital Henri Mondor, AP-HP, Creteil; Hematology Department, Medical University, Nice; Hematology Department, Medical University, Lille; Hematology Department, Medical University, Toulouse; Hematology Department, Medical University, Clermont-Ferrand; Hematology Department, Institut Gustave-Roussy, Villejuif; and the Unité de Greffe de Moelle Osseuse, Centre Hospitalier Universitaire, Lyon, France

Corresponding author: Steven Le Gouill, MD, PhD, Hematology Department, University Hospital, Hôtel-Dieu, Nantes, France; e-mail: steven.legouill{at}chu-nantes.fr

Purpose: Aggressive T-cell lymphomas (ATCLs) represent 10% to 15% of non-Hodgkin's lymphomas (NHLs) in adults. ATCLs show a worse prognosis than B-cell lymphomas.

Patients and Methods: On behalf of the Société Française de Greffe de Moëlle et de Thérapie Cellulaire, we conducted a retrospective analysis including 77 ATCL patients who underwent allogeneic stem-cell transplantation (alloSCT).

Results: The different diagnosis included anaplastic large-cell lymphoma (ALCL; n = 27), peripheral T-cell lymphoma not otherwise specified (PTCL-NOS; n = 27), angioimmunoblastic T-cell lymphoma (AITL; n = 11), hepatosplenic / lymphoma (HSL; n = 3), T-cell granular lymphocytic leukemia (T-GLL; n = 1), nasal natural killer (NK)/T-cell lymphoma (nasal-NK/L; n = 3) or non-nasal NK/T-cell lymphoma (non-nasal-NK/L; n = 2), enteropathy-type T-cell (n = 1), and human T-lymphotropic virus (HTLV)-1 lymphoma (n = 2). Fifty-seven patients received a myeloablative conditioning regimen. Donors were human leukocyte antigen (HLA)-matched in 70 cases and related in 60 cases. Thirty-one patients were in complete remission (CR) at the time of alloSCT, whereas 26 were in partial response (PR). Five-year toxicity-related mortality (TRM) incidence was 33% (95% CI, 24% to 46%). The 5-year overall survival (OS) and event-free survival (EFS) rates were 57% (95% CI, 45% to 68%) and 53% (95% CI, 41% to 64%), respectively. In multivariate analysis, chemoresistant disease (stable, refractory, or progressing disease) at the time of alloSCT and the occurrence of severe grade 3 to 4 acute graft-versus-host disease (aGVHD) were the strongest adverse prognostic factors for OS (P = .03 and .03, respectively). Disease status at transplantation significantly influenced the 5-year EFS (P = .003), and an HLA-mismatched donor increased TRM (P = .04).

Conclusion: We conclude that alloSCT is a potentially efficient therapy for NK/T lymphomas and is worth further investigation through prospective clinical trials.

published online ahead of print at www.jco.org on April 7, 2008

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.