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Multicenter Study
. 2021 Jan-Dec:30:963689721999615.
doi: 10.1177/0963689721999615.

Myeloablative Haploidentical Transplant as an Alternative to Matched Sibling Transplant for Peripheral T-Cell Lymphomas

Gu Zhenyang  1 , Li Nainong  2 , Wu Xiaoxiong  3 , Wang Maihong  4 , Fu Xiaorui  5 , Wang Zhao  6 , Ren Hanyun  7 , Li Yuhang  8 , Li Xiaofan  2 , Wu Yamei  3 , Liu Yao  4 , Zhang Mingzhi  5 , Wang Yini  6 , Liu Daihong  1 , Dong Yujun  7 , Hu Liangding  8 , Huang Wenrong  1
Affiliations
Multicenter Study

Myeloablative Haploidentical Transplant as an Alternative to Matched Sibling Transplant for Peripheral T-Cell Lymphomas

Gu Zhenyang et al. Cell Transplant. 2021 Jan-Dec.

Abstract

The number of HLA-haploidentical allogeneic hematopoietic stem-cell transplantation (Haplo-HSCT) is increasing. Comparative studies about Haplo-HSCT versus allo-HSCT with HLA-matched sibling donors (MSD-HSCT) have been tried in leukemias and B-cell lymphomas. Few studies were reported in Peripheral T-cell lymphomas (PTCLs). We performed a multicenter retrospective study about 52 patients with PTCLs undergoing Haplo-HSCT (n = 20) or MSD-HSCT (n = 32). All Haplo-HSCT recipients received antithymocyte globulin (ATG) based graft versus host disease (GVHD) prophylaxis. The median follow-up for all survivors was 38 months. The 100-day cumulative incidence of grade II to IV acute GVHD was similar (19% in the MSD-HSCT group versus 28% in the Haplo-HSCT group, P = 0.52). The 2-year cumulative incidence of chronic GVHD (limited and extensive) after Haplo-HSCT (30%) was also similar with that in the MSD-HSCT group (50%, P = 0.15). The 3-year relapse rates (33% vs 27%, P = 0.84) and non-relapse mortality (21% vs 22%, P = 0.78) did not differ between these two groups. There were also no differences in 3-year overall survival (OS) (48% vs 50%, P = 0.78) and progression-free survival (47% vs 51%, P = 0.95) between these two groups. On multivariate analysis, prognostic index for T-cell lymphoma (PIT) score (higher than 1: hazard ratio [HR], 4.0; P = 0.003) and disease status (stable or progression disease before HSCT: HR, 2.8; P = 0.03) were independent variables associated with worse OS. We concluded that ATG-based haplo-HSCT platform could work as an alternative to MSD-HSCT for patients with PTCLs.

Keywords: HLA-matched sibling donor; allo-HSCT; antithymocyte globulin; haploidentical donor; peripheral t-cell lymphoma.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
(A) Cumulative incidence of 100-day grade Ⅱ-Ⅳ acute graft versus host disease (aGVHD) after allo-HSCT. (B) Cumulative incidence of 2-year limited and extensive chronic GVHD (cGVHD) after allo-HSCT. The cumulative incidences of both aGVHD and cGVHD were estimated with competing-risk analysis and compared with Gray’s test. Haplo-HSCT, allo-HSCT with HLA-haploidentical donors; MSD-HSCT, allo-HSCT with HLA matched sibling donors.
Figure 2.
Figure 2.
(A) The cumulative incidence of non-relapse mortality (NRM) at 3-year was 22% (95% CI, 6%–43%) in the haplo-HSCT group versus 21% (95% CI, 8%–37%) in the MSD-HSCT group. (B) The 3-year relapse rate was 27% (95% CI, 9%–48%) in the Haplo-HCT group versus 33% (95% CI, 17%–50%) in the MSD group. The cumulative incidences of both NRM and relapse were estimated with competing-risk analysis and compared with Gray’s test. Haplo-HSCT, allo-HSCT with HLA-haploidentical donors; MSD-HSCT, allo-HSCT with HLA matched sibling donors.
Figure 3.
Figure 3.
Kaplan-Meier survival analysis. (A) The 3-year overall survival (OS) was 49.9% (95% CI, 31%–80%) in the Haplo-HSCT group versus 48.2% (95% CI, 33%–71%) in the MSD-HSCT group. (B) The 3-year progression free survival (PFS) was 51% (95% CI, 33%–90%) in the Haplo-HSCT groups versus 47% (95% CI, 32%–69%) in the MSD group. Haplo-HSCT, allo-HSCT with HLA-haploidentical donors; MSD-HSCT, allo-HSCT with HLA matched sibling donors.
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