TBI-ATG based conditioning regimen is a promising approach for adult patients with refractory and relapsed peripheral T cell lymphoma undergoing allogeneic peripheral blood stem cell transplantation

Abstract PTCL are a heterogeneous group of lymphoproliferative disorders generally associated with dismal clinical outcomes, especially in the R/R context. Allo-SCT as the potentially curative therapeutic option for R/R PTCL patients, fails to provide lasting tumor control. Our previous research has confirmed that an ATG-based conditioning regimen is a feasible and effective alternative for patients with aggressive TCLs. A retrospective analysis was conducted on patients with advanced R/R PTCL who underwent allo-SCT at our center. All the patients treated with the TBI-ATG-based myeloablative conditioning regimen. Thirty-seven R/R PTCL patients, with a median age of 51 years at transplantation, were analyzed. All patients had experienced relapse or primary progression of T-cell lymphoma prior to allo-SCT. Specifically, 5 patients had achieved PR in response to their last salvage treatment and 32 patients had PD at the start of conditioning for allo-SCT. All patients successfully engrafted and achieved full donor chimerism. At a median follow-up of 25.8 months, the 2-year OS and PFS were 61.69% and 58.73%, respectively. Thirty-one cases underwent haplo-allo-HSCT. The 2-year OS and PFS for this subgroup were 68.09% and 58.34%, respectively. Five cases who achieved PR prior to allo-SCT, with a median follow-up of 38.5 months, all are alive and disease-free. Additionally, in the subgroup of 32 cases who were in PD status prior to allo-SCT, the 2-year OS and PFS were 54.89% and 50.77%, respectively. The 2-year relapse rate (RR) was 31.59% and 2-year relapse-related mortality (RRM) was 16.95%. The 2-year NRM was 25.53%.