GHANDI(LAURENT(DAMAJ((CAEN)
(
ALLOGENEIC(STEM(CELL(TRANSPLANTATION(IN(PTCL(PATIENTS(
(WHY(AND(WHEN?(
(
University(Hospital,(Hematology(Institute,(School(of(medicine,(Normandy(University,(Caen,(France(
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Peripheral!T!cell!Lymphoma!(PTCL)!is!a!heterogenous!disease!which!accounts!for!12!–!15%!of!
all! lymphoma.! It! is! a! difficult! to! treat! disease! with! poor! prognosis.! Therapeutic! option! are!
limited!and!patients!who!are!disease!free!with!long!term!survival!are!rare,!account!for!less!
than!30%!of!all!PTCL!patients.!!
First! line! therapy! with! CHO(E)P,! for! non>ALCL! lymphoma! patients,! remains! the! most! used!
therapy!today,!in!the!absence!of!better!combination!chemotherapy.!The!median!time!from!
PTCL! diagnosis! to! relapse! or! progression! is! 6! to! 7! months.! The! majority! of! patients! will!
relapse! or! experience! progression! before! 2! years! after! first! line! therapy.! The! prognosis! of!
these!patients!is!dismal!with!a!median!progression!free!survival!(PFS)!of!less!the!4!months!
and!overall!survival!(OS)!of!less!than!6.5!months.!
Novel! single! agents! have! been! used! in! the! last! decade! such! as! romidepsin,! pralatrexate,!
bendamustine!and!alisertib,!etc.,!The!results!obtained!with!these!drugs!remain!!insufficient!
and!new!drugs!and!others!strategies!are!needed!to!improve!the!outcome!of!patients!with!
PTCL.!
Based! on! its! immunologic! effect! against! T>cell! lymphoma,! allogeneic! stem! cell!
transplantation!have!been!used!with!true!potential!curative!effect.!
The!first!prospective!study!in!17!patients!(Corradini!et!al,!2004),!showed!an!excellent!long!
term!effect!of!this!procedure!with!long!term!PFS!!of!64%,!OS!of!80%!and!low!toxic!death!with!
the!use!of!reduced!intensity!conditioning!regimen.!
Another! studies! mainly! retrospective,! showed! and! excellent! anti! lymphoma! effect! in! the!
setting!of!refractory!or!relapsed!PTCL!patients.!The!median!PFS!and!OS!ranged!from!34%!to!
53%!and!40%!to!59%!respectively.!
Due!the!dismal!prognosis!of!PTCL,!many!patients!have!been!treated!with!front!line!Allo>SCT.!
In! the! largest! retrospective! study! published! recently! (Mamez! et! al;! 2020),! 138! patients!
received! Allo>SCT! in! 1st! complete! remission! (CR=93)! or! 1st! partial! remission! (PR=45)! .! The!
median!4>y!OS!was!63%!for!the!whole!group!and!62%!for!patients!in!CR1.!!
Loirat!et!al!(Ann!Onco!2015),!reported!!from!one!center,!on!29!PTCL!patients!receiving!allo>
SCT!in!first!response.!The!2>y!OS!was!72.5%!and!the!2>y!NRM!was!low!after!RIC!conditioning!
of!8%.!
The!only!randomized!study!reported!recently,!the!AATT!study,!randomized!patients!between!
autologous! and! allogeneic! SCT! in! first! line! responders! patients.! After! 4! cycles! of! CHOEP!
chemotherapy,! complete! and! partial! responder! patients! as! well! as! patients! with! stable!
disease,! received! one! cycle! of! DHAP! chemotherapy! followed! by! stem! cell! collection.! 103!
patients!were!analyzed!(Intent!to!treat);!54!patients!in!the!autologous!arm!and!49!patients!
in!the!allo>SCT!arm.!After!a!median!observation!time!of!42!months,!the!3!years!EFS!in!the!
auto! and! allo! arms! was! 38%! and! 43%! respectively! (p=0.583);! 3>y! EFS! for! transplanted!
patients!was!82%!and!71%!for!auto!and!allo!arms!respectively.!The!were!no!difference!in!the!
OS! between! the! 2! arms! (p=0.408)! with! more! toxic! death! in! the! allo>SCT! arm! and! more!
relapses!in!the!auto!arm.!
SCIENTIFIC PROGRAMME
SESSION I
HODGKIN’S DISEASE
DEBATE I
IS THERE STILL A ROLE
FOR COMBINED MODALITY
THERAPY FOR EARLY
STAGE CHL?
SESSION II
T-CELL LYMPHOMA
ROUNDTABLE I
FUTURE DIRECTIONS IN
T-CELL LYMPHOMA
SESSION III
FOLLICULAR LYMPHOMA
DEBATE II
CAN WE AVOID
CHEMOTHERAPY IN
THE MANAGEMENT OF
FOLLICULAR LYMPHOMA?
SESSION IV
RARE LYMPHOMAS –
MARGINAL ZONE
LYMPHOMA AND
WALDENSTRÖM M
ACROGLOBULINEMIA
ROUNDTABLE II – WHERE
TO GO IN RARE B-CELL
LYMPHOMAS
SESSION V
MANTLE CELL LYMPHOMA
SESSION VI
DIFFUSE LARGE B-CELL
LYMPHOMA
DEBATE III
DO WE STILL NEED ASCT
IN MCL?
SESSION VII
NOVEL THER APEUTIC
CONCEPTS IN B-CELL
LYMPHOMAS
SELECTED ABSTRACTS
FOR AN ORAL
PRESENTATION
SELECTED ABSTRACTS
FOR A POSTER
PRESENTATION
DISCLOSURES