Allogeneic Hematopoietic Stem Cell Transplantation (HSCT) provides a potentially curative option for patients affected by primary Cutaneous T-Cell Lymphoma (CTCL) in advanced stage. We are reporting 13 patients (8 F; 5 M) with a median age of 52 years (range 41-64 yrs) affected by advanced CTCL. Diagnosis were: panniculitis-like T-cell lymphoma (n=1) large T-cell lymphoma (n=3), NK T-cell lymphoma (n=1), Mycosis Fungoides (MF, n=2), Sezary Syndrome (SS, n=6). Seven patients had a relapsed/refractory disease, 4 patients were in partial remission and 2 in complete remission. All patients but 1 were heavily pretreated and 3 had undergone a previous auto- logous transplant. Six patients were transplanted from a HLA identical sibling, 1 from a HLA mismatched sibling, 4 patients were transplanted from a matched unrelated donor and 2 from umbilical cord blood (UCB) unit. Nine patients received a RIC regimen consisted of thiotepa, fludarabine and cyclophos- phamide (n=7) and thiotepa, fludarabine and busulfan (n=2). Four patients received a myeloablative conditioning (MAC) consisted of cyclophosphamide and busulfan in 2 patients and thiotepa and fludarabine and busulfan in 2. Cyclosporine and methotrexate were used as GVHD prophylaxis in HLA identical transplant. UCB transplant received cyclosporine and myco- phenolate mofetil and cyclosporine and prednisone, respec- tively. Thymoglobulin was added in mismatched transplant. Neutrophil and platelet engraftment were achieved in all but one patients. A grade I-II acute GVHD developed in 4 patients, grade III-IV in one. Chronic GVHD (cGVHD) was observed in 11 patients: 9 limited and two extended. Eleven patients were evaluable for response (2 too early) and achieved a complete remission. Five patients experienced relapse at 3, 8, 9, 10, 17 months from HSCT. Three of them infused donor lymphocyte: a second durable remission was obtained in 2 SS patients, no response was observed in patient with NK T lymphoma. Trans- plant-related mortality occurred in four patients (3 MAC regi- men, 1 RIC regimen). They died as result of multiorgan failure (n=3) and infection plus extensive cGVHD (n=1), 2 at 3 months, 1 at 7 months, 1 at 11. To date at median follow up of 45 months (range 20-85) 9 patients are alive, 6 without evidence of lym- phoma. Our results show a lower transplant-related toxicity by using RIC regimen, suggest a potential curative effect of allogeneic RIC transplant and indicate the existence of a graft versus tumor effect in CTCL.

Cudillo, L., Di Veroli, A., Mariotti, B., Ceresoli, E., Picardi, A., Cerretti, R., et al. (2012). Allogeneic stem cell transplantation for patients with advanced primary cutaneous T-cell lymphoma. ??????? it.cilea.surplus.oa.citation.tipologie.CitationProceedings.prensentedAt ??????? 38th Annual Meeting of the European-Group-for-Blood-and-Marrow-Transplantation (EBMT), Geneva, SWITZERLAND.

Allogeneic stem cell transplantation for patients with advanced primary cutaneous T-cell lymphoma

PICARDI, ALESSANDRA;CANTONETTI, MARIA;ARCESE, WILLIAM
2012-01-01

Abstract

Allogeneic Hematopoietic Stem Cell Transplantation (HSCT) provides a potentially curative option for patients affected by primary Cutaneous T-Cell Lymphoma (CTCL) in advanced stage. We are reporting 13 patients (8 F; 5 M) with a median age of 52 years (range 41-64 yrs) affected by advanced CTCL. Diagnosis were: panniculitis-like T-cell lymphoma (n=1) large T-cell lymphoma (n=3), NK T-cell lymphoma (n=1), Mycosis Fungoides (MF, n=2), Sezary Syndrome (SS, n=6). Seven patients had a relapsed/refractory disease, 4 patients were in partial remission and 2 in complete remission. All patients but 1 were heavily pretreated and 3 had undergone a previous auto- logous transplant. Six patients were transplanted from a HLA identical sibling, 1 from a HLA mismatched sibling, 4 patients were transplanted from a matched unrelated donor and 2 from umbilical cord blood (UCB) unit. Nine patients received a RIC regimen consisted of thiotepa, fludarabine and cyclophos- phamide (n=7) and thiotepa, fludarabine and busulfan (n=2). Four patients received a myeloablative conditioning (MAC) consisted of cyclophosphamide and busulfan in 2 patients and thiotepa and fludarabine and busulfan in 2. Cyclosporine and methotrexate were used as GVHD prophylaxis in HLA identical transplant. UCB transplant received cyclosporine and myco- phenolate mofetil and cyclosporine and prednisone, respec- tively. Thymoglobulin was added in mismatched transplant. Neutrophil and platelet engraftment were achieved in all but one patients. A grade I-II acute GVHD developed in 4 patients, grade III-IV in one. Chronic GVHD (cGVHD) was observed in 11 patients: 9 limited and two extended. Eleven patients were evaluable for response (2 too early) and achieved a complete remission. Five patients experienced relapse at 3, 8, 9, 10, 17 months from HSCT. Three of them infused donor lymphocyte: a second durable remission was obtained in 2 SS patients, no response was observed in patient with NK T lymphoma. Trans- plant-related mortality occurred in four patients (3 MAC regi- men, 1 RIC regimen). They died as result of multiorgan failure (n=3) and infection plus extensive cGVHD (n=1), 2 at 3 months, 1 at 7 months, 1 at 11. To date at median follow up of 45 months (range 20-85) 9 patients are alive, 6 without evidence of lym- phoma. Our results show a lower transplant-related toxicity by using RIC regimen, suggest a potential curative effect of allogeneic RIC transplant and indicate the existence of a graft versus tumor effect in CTCL.
38th Annual Meeting of the European-Group-for-Blood-and-Marrow-Transplantation (EBMT)
Geneva, SWITZERLAND
2012
Rilevanza internazionale
Settore MED/15 - Malattie del Sangue
Settore MED/06 - Oncologia Medica
English
Intervento a convegno
Cudillo, L., Di Veroli, A., Mariotti, B., Ceresoli, E., Picardi, A., Cerretti, R., et al. (2012). Allogeneic stem cell transplantation for patients with advanced primary cutaneous T-cell lymphoma. ??????? it.cilea.surplus.oa.citation.tipologie.CitationProceedings.prensentedAt ??????? 38th Annual Meeting of the European-Group-for-Blood-and-Marrow-Transplantation (EBMT), Geneva, SWITZERLAND.
Cudillo, L; Di Veroli, A; Mariotti, B; Ceresoli, E; Picardi, A; Cerretti, R; De Angelis, G; Rizzo, M; Pisani, F; Cantonetti, M; Lombardo, G; Scala, E; Arcese, W
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/69196
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