Salvage
chemotherapy induces disease remissions in patients with relapsed or refractory (r/r)
T-cell lymphomas, but fails to provide lasting
tumor control. We analyzed the outcome after peripheral blood stem and
bone marrow transplantation (PBSCT, n = 80; BMT, n = 4) from matched related (MRD, n = 22) or matched and unmatched unrelated donors (MUD and MMD, n = 53 and n = 9, respectively) following conditioning with
fludarabine,
busulfan, and
cyclophosphamide (FBC) for 84 consecutive patients with r/r T-cell
malignancies. At start of conditioning LDH was elevated in 50% of cases, and
residual tumor (PD, SD, PR) was detectable in 84% of patients. In total, 38% (95% CI 33-44) of the patients were alive and disease-free after a median observation time of 14.5 (range 1.8 to 114) months. Univariate and multivariate analyses identified low ECOG status, as well as occurrence of acute GvHD as favorable factors for outcome.
Lymphoma-directed conditioning with fludarabin,
busulfan and cyclophosphamid (FBC-12), and allogeneic
stem cell transplantation resulted in long-term survival for a proportion of patients with r/r
peripheral T-cell lymphoma, including those with PR and SD only after
salvage therapy.