Cancer Treatment

A Randomized Phase 3 Trial Of Autologous Vs Allogeneic Transplantation As Part Of First-Line Therapy In Poor-Risk Peripheral T-NHL

A Randomized Phase 3 Trial Of Autologous Vs Allogeneic Transplantation As Part Of First-Line Therapy In Poor-Risk Peripheral T-NHL

Patients with advanced peripheral T-cell non-Hodgkin’s lymphoma, have poor prognosis.  The role of allogenic stem cell transplantation has not been well-defined in this patient population.  In the May 13, 2021 issue of the journal Blood, investigators report on a study utilizing planned allogeneic stem cell transplantation in this patient population.  

104 patients, excluding those with ALK positive anaplastic large cell lymphoma, between the ages of 18 and 60, were randomized to 4 cycles of CHOEP and 1 cycle of dexamethasone, ara-C, platinum agent (DHAP) followed by high-dose chemotherapy and autologous stem cell transplantation or myeloablative conditioning and allogeneic stem cell transplantation.  The primary endpoint at 3 years was event free survival.  

After a median follow-up of 42 months, the event free survival at 3 years after allogeneic stem cell transplantation was 43% compared with 38% after autologous stem cell transplantation. 3-year overall survival was 57% versus 70% after allogeneic or autologous stem cell transplantation, without significant differences between treatment arms.  Of the 21 responding patients, who proceeded to allogeneic stem cell transplantation, none had a relapse.  This was compared to 13 of 36 patients in the autologous stem cell transplant arm.  31% of patients and 0% of patients died of transplant associated toxicity after allogeneic and autologous stem cell transplantation respectively.  

The authors concluded “the stronger graft versus lymphoma effect after allogeneic stem cell transplantation was counterbalanced by transplant related mortality.”

https://ashpublications.org/Blood/article-abstract/137/19/2646/474742/A-randomized-phase-3-trial-of-autologous-vs?redirectedFrom=fulltext

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