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Allogeneic hematopoietic stem cell transplantation in Primary Cutaneous T Cell Lymphoma

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Abstract

In our retrospective study, 16 patients affected by advanced cutaneous T cell lymphoma (CTCL) underwent allogeneic hematopoietic stem cell transplantation (HSCT). Two patients (12.5%) were in complete remission (CR), nine (56.3%) in partial remission (PR), and five (31.2%) with active disease. The patients were transplanted from an HLA-identical (n = 7) from a mismatched (n = 1) or haploidentical (n = 1) sibling, from matched unrelated donor (n = 5), or from a single cord blood unit (n = 2). Conditioning regimen was standard myeloablative in 6 patients and at reduced intensity in 10. Seven patients died from non relapse mortality (NRM) and four patients relapsed or progressed, three of them achieved a second CR after donor lymphocyte infusion (DLI) or chemotherapy plus DLI. To date, with a median follow-up of 76 months (range 6–130), nine patients are alive, eight in CR, and one with active disease. Overall survival (OS) and disease-free survival (DFS) at 1 and 10 years are 61% (95% CI 40–91%) and 54% (95% CI 33–86%), 40% (95% CI 22–74%), and 34% (95% CI 16–68%), respectively. The time from diagnosis to transplant seems to influence negatively both OS (log-rank p < 0.04) and DFS (log-rank p < 0.05). Our results confirm on a long follow-up that CTCL appears particularly susceptible to the graft versus lymphoma (GVL) effect, so that allogeneic HSCT represents a possibility of cure for advanced CTCL. The timing of HSCT in the clinical course of disease remains an open issue.

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Authors and Affiliations

  1. Hematology and Stem Cell Transplant Unit, Tor Vergata University, Viale Oxford 81, 00133, Rome, Italy

    Laura Cudillo, Raffaella Cerretti, Alessandra Picardi, Benedetta Mariotti, Gottardo De Angelis, Maria Cantonetti, Massimiliano Postorino, Eleonora Ceresoli, Giovanna De Santis, Daniela Nasso & Fabio Di Piazza

  2. Hematology, Regina Elena National Cancer Institute, Rome, Italy

    Francesco Pisani

  3. Istituto Dermatopatico Immacolata IRCCS, Rome, Italy

    Enrico Scala

  4. Immunohematology, University Tor Vergata, Rome, Italy

    Alessandro Lanti

Authors
  1. Laura Cudillo
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  2. Raffaella Cerretti
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  3. Alessandra Picardi
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  4. Benedetta Mariotti
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  5. Gottardo De Angelis
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  6. Maria Cantonetti
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  7. Massimiliano Postorino
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  8. Eleonora Ceresoli
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  9. Giovanna De Santis
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  11. Francesco Pisani
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  12. Enrico Scala
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  13. Fabio Di Piazza
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  14. Alessandro Lanti
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William Arcese for the Rome Transplant Network

Corresponding author

Correspondence to Laura Cudillo.

Ethics declarations

All procedures performed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

All patients provided written informed consent for being included in the transplant procedure.

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The authors declare that they have no conflict of interest.

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Cudillo, L., Cerretti, R., Picardi, A. et al. Allogeneic hematopoietic stem cell transplantation in Primary Cutaneous T Cell Lymphoma. Ann Hematol 97, 1041–1048 (2018). https://doi.org/10.1007/s00277-018-3275-z

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  • DOI: https://doi.org/10.1007/s00277-018-3275-z

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