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Bone Marrow Transplant. 2016 Mar;51(3):358-64. doi: 10.1038/bmt.2015.280. Epub 2015 Nov 23.

Effect of immune modulation in relapsed peripheral T-cell lymphomas after post-allogeneic stem cell transplantation: a study by the Société Française de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC).

Author information

1
Service d'hématologie, Hôpital Saint Antoine, 184 rue du faubourg Saint Antoine, Paris, France.
2
Unité de Recherche Clinique, Hôpital Avicenne, Bobigny, Cedex, France.
3
Service d'hématologie, CHU Nantes, 1 Place Alexis-Ricordeau, Nantes, France.
4
Service d'hématologie, Institut Paoli Calmette, Marseille, France.
5
Hôpital du Haut Lévêque Service d'Hématologie, Pessac, France.
6
Service d'hématologie, greffe de moelle, Hôpital Saint Louis, Paris, France.
7
Service d'hématologie, CHU Montpellier, 191 avenue du Doyen Gaston Giraud, Montpellier, France.
8
Service d'hématologie, CHU Rouen, Rue d'Amiens, Cedex 1, France.
9
University of Liège, Department of Hematology, CHU Sart-Tilman, CHU de Liège, Domaine Universitaire du Sart Tilman, Liège 1, Belgium.
10
Service d'hématologie, CHU, Angers, France 4 Rue Larrey, Angers, France.
11
Service d'hématologie, CHU Grenoble, boulevard de la Chantourne, Grenoble cedex 09, France.
12
Service d'hématologie, Hôpital Necker, Paris, France.
13
Service d'hématologie, CHRU Lille, 2 avenue Oscar Lambret, CEDEX, France.
14
Service d'hématologie, CHU Dupuytren, Limoges cedex, France.
15
Service d'hématologie, CHRU Besançon, 2 boulevard Fleming, Besançon, France.
16
Service d'hématologie, CHU Rennes, 2 rue Henri Le Guilloux, cedex 9, France.
17
Service d'hématologie, CHU Purpan, Place du Dr Baylac, Toulouse, France.
18
Service d'hématologie, Hôpital Henri Mondor, Créteil, France.
19
Service d'hématologie, CHRU Strasbourg, Hôpital Hautepierre, Strasbourg, France.
20
Service d'hématologie, Hematologie Clinique, Hôpital Pitié Salpêtrière, boulevard de l'Hôpital, Paris cedex 13, France.
21
Service d'hématologie, Hôpital d'Estaing, CHU Clermond Ferrand,1 place Lucie-Aubrac, Clermont-Ferrand Cedex 1, France.
22
Service d'hématologie, CHU Brest, Hôpital Morvan, Cedex, France.
23
Service d'hématologie, CHU Poitiers, CHRU La Miletrie, Poitiers Cedex, France.
24
Service d'hématologie, CHU Lyon, Centre Hospitalier Lyon-Sud 165 chemin du Grand Revoyet, Pierre Bénite Cedex, France.
25
Service d'hématologie, Hôpital d'instruction des armées Percy, Clamart, France.
26
Service d'hématologie, Institut Gustave Roussy, 114 r Edouard Vaillant, Villejuif CEDEX, France.
27
Service d'hématologie pédiatrique, CHU Nantes, Hôtel Dieu,1 place Alexis-Ricordeau, Nantes, France.
28
Service d'hématologie, CHU Caen, Avenue de la Côte de nacre, Caen cedex 9, France.
29
Service d'hématologie pédiatrique, CHU Bordeaux Pellegrin - Place Amélie Raba Léon, Bordeaux, France.

Abstract

Peripheral T-cell lymphoma carries a poor prognosis. To document a possible graft-versus-lymphoma effect in this setting, we evaluated the impact of immunomodulation in 63 patients with peripheral T-cell lymphoma who relapsed after allogeneic transplant in 27 SFGM-TC centers. Relapse occurred after a median of 2.8 months. Patients were then treated with non-immunologic strategies (chemotherapy, radiotherapy) and/or immune modulation (donor lymphocyte infusions (DLI) and/or discontinuation of immunosuppressive therapy). Median overall survival (OS) after relapse was 6.1 months (DLI group: 23.6 months, non-DLI group: 3.6 months). Among the 14 patients who received DLI, 9 responded and 2 had stable disease. Among the remaining 49 patients, a complete response accompanied by extensive chronic GvHD was achieved in two patients after tapering of immunosuppressive drugs. Thirty patients received radio-chemotherapy, with an overall response rate of 50%. In multivariate analysis, chronic GvHD (odds ratio: 11.25 (2.68-48.21), P=0.0009) and skin relapse (odds ratio: 4.15 (1.04-16.50), P=0.043) were associated with a better response to treatment at relapse. In a time-dependent analysis, the only factor predictive of OS was the time from transplantation to relapse (hazards ratio: 0.33 (0.17-0.640), P=0.0009). This large series provides encouraging evidence of a true GvL effect in this disease.

PMID:
26595076
DOI:
10.1038/bmt.2015.280
[Indexed for MEDLINE]
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