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
Year: 2025
Type: article
Study design: Observational Study
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.
Source: HemaSphere
DOI: 10.1002/hem3.70184
Authors: Philipp Berning, Maud Ngoya, Won Seog Kim, Evgenii Shumilov, Depei Wu, Haiwen Huang, Anne Cairoli, Alessandra Tucci, Guillaume Dachy, Romain Gounot, Anne C. Wilke, Christof Scheid, Peter Dreger, Jose Luis Lopez Lorenzo, Adrian Bloor, Joanna Romejko‐Jarosinska, Alain Gadisseur, Roland Schroers, Péter Reményi, Ludovic Gabellier, Monica Poiani, Khalid Halahleh, Jacques‐Emmanuel Galimard, Georg Lenz, Anna Sureda, Ali Bazarbachi, Bertram Glass, Norbert Schmitz
Institutions: University Hospital Münster, European Society for Blood and Marrow Transplantation, Samsung Medical Center, Sungkyunkwan University, First Affiliated Hospital of Soochow University, Centre Hospitalier Universitaire Vaudois, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Cliniques Universitaires Saint-Luc, Centre Hospitalier Universitaire Henri-Mondor, Hôpitaux Universitaires Henri-Mondor, Goethe University Frankfurt, University Hospital Frankfurt, University of Cologne, University Hospital Cologne, Heidelberg University, Hospital Universitario Fundación Jiménez Díaz, The Christie Hospital, The Christie NHS Foundation Trust, The Maria Sklodowska-Curie National Research Institute of Oncology, Antwerp University Hospital, Universitätsklinikum Knappschaftskrankenhaus Bochum, Centre Hospitalier Universitaire de Montpellier, Azienda sanitaria universitaria Giuliano Isontina, King Hussein Cancer Center, Institut d'Investigació Biomédica de Bellvitge, Institut Català d'Oncologia, Universitat de Barcelona, American University of Beirut Medical Center, Helios Hospital Berlin-Buch
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,480
OpenAlex ID: W4413309137