Allogeneic stem cell transplantation against aggressive lymphomas: graft-versus-lymphoma effects in peripheral T-cell lymphoma and diffuse large B-cell lymphoma after myeloablative conditioning

Leuk Lymphoma. 2025 Apr;66(4):668-679. doi: 10.1080/10428194.2024.2438805. Epub 2024 Dec 11.

Abstract

Allogeneic stem cell transplantation (alloSCT) represents a curative option for patients with relapsed/refractory (r/r) aggressive lymphomas. We compared outcomes of alloSCT in r/r PTCL and r/r DLBCL pts (n = 150) who underwent identical myeloablative conditioning chemotherapy, GvHD prophylaxis, and relapse management. 5-year PFS and OS were significantly superior in PTCL compared to DLBCL (56% vs. 24%; 56% vs. 28%; p ≤ 0.005). A landmark analysis (day≥ +100 post-alloSCT) markedly favored outcomes in PTCL vs. DLBCL: 5-year PFS and OS of 76% vs. 30% and 76% and 35%, respectively (p ≤ 0.003). Non-relapse mortality was comparable (35% PTCL vs. 34% DLBCL, p = 0.894), whereas post-alloSCT relapse mortality was significantly higher in DLBCL (36% vs. 10%, p = 0.0007). The occurence of limited chronic GvHD did not improve outcomes in DLBCL, whereas extensive chronic GvHD was a negative risk factor for both (HR 2.09 and 2.80, p ≤ 0.006). In conclusion, we gained evidence for strong graft-versus-lymphoma activity against PTCL but not DLBCL.

Keywords: DLBCL; FBC12; GvL; TPCL; salvage allogeneic SCT.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Graft vs Host Disease / etiology
  • Graft vs Host Disease / prevention & control
  • Graft vs Tumor Effect* / immunology
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Hematopoietic Stem Cell Transplantation* / methods
  • Humans
  • Lymphoma, Large B-Cell, Diffuse* / mortality
  • Lymphoma, Large B-Cell, Diffuse* / pathology
  • Lymphoma, Large B-Cell, Diffuse* / therapy
  • Lymphoma, T-Cell, Peripheral* / mortality
  • Lymphoma, T-Cell, Peripheral* / pathology
  • Lymphoma, T-Cell, Peripheral* / therapy
  • Male
  • Middle Aged
  • Myeloablative Agonists / therapeutic use
  • Retrospective Studies
  • Transplantation Conditioning* / adverse effects
  • Transplantation Conditioning* / methods
  • Transplantation, Homologous
  • Treatment Outcome
  • Young Adult

Substances

  • Myeloablative Agonists