Autologous stem cell transplantation in NK/T‐cell lymphoma: Prognostic impact of EBV‐DNA in a multinational cohort—A study by the EBMT Lymphoma Working Party

Natural killer (NK)/T-cell lymphomas (NKTCLs) are rare, aggressive lymphomas prevalent in East Asia and South America. Despite improvements, largely due to asparaginase-based therapies, outcomes for advanced disease remain poor, and the role of autologous stem cell transplantation (auto-HCT) remains controversial. This study evaluated real-world outcomes of auto-HCT in NKTCL patients across Asia and Europe. We included 130 adult NKTCL patients undergoing auto-HCT between 2011 and 2022 using data from the European Society for Blood and Marrow Transplantation (EBMT) registry and South Korean registry data. Median age was 51.3 years; 66.9% were male. Most patients (95.1%) had an Eastern Cooperative Oncology Group (ECOG) score 0-1; 65.3% had Stage III-IV disease. One prior therapy line was reported in 53.1%, and ≥2 lines in 46.9%. Asparaginase-based regimens were used in 79.5% pretransplant. Responses at auto-HCT included complete (59.7%), partial (27.9%) remission, and stable/progressive disease (12.4%). Epstein-Barr virus (EBV)-DNA in the peripheral blood was reported in 37.3%. With a median follow-up of 4.6 years, 3-year overall survival (OS) and progression-free survival (PFS) were 63.8% and 47.6%. Relapse and NRM rates at 3 years were 46.7% and 5.7%. Patients in complete remission had improved 3-year OS (75.2%) compared to PR (52.8%) and stable/progressive disease (32.0%) (P = 0.007). Detectable EBV-DNA in the blood at auto-HCT was associated with poor outcomes (3-year OS: 26.7% vs. 78.1% in patients with undetectable EBV-DNA; P < 0.0001). Patients achieving complete remission and undetectable EBV-DNA in the blood before auto-HCT had a favorable survival, suggesting auto-HCT may be a treatment option in selected high-risk patients. This is the largest multinational cohort evaluating prognostic factors for auto-HCT for NKTCL.

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Journal
HemaSphere
Published
2025-08-01
DOI
https://doi.org/10.1002/hem3.70184
Citations
1
Primary Topic
Lymphoma Diagnosis and Treatment
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article
Field-Weighted Citation Impact
1.47
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article

Autologous stem cell transplantation in NK/T‐cell lymphoma: Prognostic impact of EBV‐DNA in a multinational cohort—A study by the EBMT Lymphoma Working Party

Norbert Schmitz, Guillaume Dachy, Christof Scheid, Monica Poiani et al.
1 citations
HemaSphere
Lymphoma Diagnosis and Treatment
1.47
article

Autologous stem cell transplantation in NK/T‐cell lymphoma: Prognostic impact of EBV‐DNA in a multinational cohort—A study by the EBMT Lymphoma Working Party

Norbert Schmitz, Guillaume Dachy, Christof Scheid, Monica Poiani, Adrian Bloor, Alain Gadisseur, Ali Bazarbachi, Roland Schroers, Georg Lenz, Philipp Berning, Maud Ngoya, José Luis López Lorenzo, Haiwen Huang, Joanna Romejko‐Jarosińska, Khalid Halahleh, Jacques‐Emmanuel Galimard, Won Seog Kim, Alessandra Tucci, Anna Sureda, Ludovic Gabellier, Anne C. Wilke, Peter Dreger, Romain Gounot, Evgenii Shumilov, Péter Reményi, Bertram Glass, Anne Cairoli, Depei Wu
article en
1 citations

Abstract

Natural killer (NK)/T-cell lymphomas (NKTCLs) are rare, aggressive lymphomas prevalent in East Asia and South America. Despite improvements, largely due to asparaginase-based therapies, outcomes for advanced disease remain poor, and the role of autologous stem cell transplantation (auto-HCT) remains controversial. This study evaluated real-world outcomes of auto-HCT in NKTCL patients across Asia and Europe. We included 130 adult NKTCL patients undergoing auto-HCT between 2011 and 2022 using data from the European Society for Blood and Marrow Transplantation (EBMT) registry and South Korean registry data. Median age was 51.3 years; 66.9% were male. Most patients (95.1%) had an Eastern Cooperative Oncology Group (ECOG) score 0-1; 65.3% had Stage III-IV disease. One prior therapy line was reported in 53.1%, and ≥2 lines in 46.9%. Asparaginase-based regimens were used in 79.5% pretransplant. Responses at auto-HCT included complete (59.7%), partial (27.9%) remission, and stable/progressive disease (12.4%). Epstein-Barr virus (EBV)-DNA in the peripheral blood was reported in 37.3%. With a median follow-up of 4.6 years, 3-year overall survival (OS) and progression-free survival (PFS) were 63.8% and 47.6%. Relapse and NRM rates at 3 years were 46.7% and 5.7%. Patients in complete remission had improved 3-year OS (75.2%) compared to PR (52.8%) and stable/progressive disease (32.0%) (P = 0.007). Detectable EBV-DNA in the blood at auto-HCT was associated with poor outcomes (3-year OS: 26.7% vs. 78.1% in patients with undetectable EBV-DNA; P < 0.0001). Patients achieving complete remission and undetectable EBV-DNA in the blood before auto-HCT had a favorable survival, suggesting auto-HCT may be a treatment option in selected high-risk patients. This is the largest multinational cohort evaluating prognostic factors for auto-HCT for NKTCL.

HemaSphereVol. 9(8)
Goethe University Frankfurt (DE), Cliniques Universitaires Saint-Luc (BE), University of Cologne (DE), Heidelberg University (DE), King Hussein Cancer Center (JO), Samsung Medical Center (KR), Centre Hospitalier Universitaire Vaudois (CH), Centre Hospitalier Universitaire Henri-Mondor (FR), Soochow University (CN), Centre Hospitalier Universitaire de Montpellier (FR), Országos Idegsebészeti Tudományos Intézet (HU), Antwerp University Hospital (BE), Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT), University Hospital Münster (DE), American University of Beirut Medical Center (LB), Institut Català d'Oncologia (ES), Universitätsklinikum Knappschaftskrankenhaus Bochum (DE), National Institute of Oncology (HU), Hospital Universitario Fundación Jiménez Díaz (ES), Hôpitaux Universitaires Henri-Mondor (FR), University Hospital Frankfurt (DE), The Christie NHS Foundation Trust (GB), Országos Reumatológiai és Fizioterápiás Intézet (HU), The Maria Sklodowska-Curie National Research Institute of Oncology (PL), First Affiliated Hospital of Soochow University (CN), University Hospital Cologne (DE), Helios Hospital Berlin-Buch (DE), European Society for Blood and Marrow Transplantation (FR), Azienda Sanitaria Universitaria Integrata di Trieste (IT), Universidad Autónoma de Madrid (ES), Sungkyunkwan University (KR), University of Lausanne (CH)
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Openalex Percentile: Top 16%
Lymphoma Diagnosis and Treatment
1.47
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