Real-world Allogeneic Transplantation in Mycosis Fungoides (reaw-cut Allo): When Is the Right Time? a Brazilian Multicenter Experience
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background Cutaneous T-cell lymphomas (CTCLs), such as Mycosis Fungoides (MF) and Sezary Syndrome (SS), are rare subtypes of non-Hodgkin lymphoma that significantly impact quality of life and have poor outcomes, particularly in advanced stages where survival rates can be less than 5 years. Diagnosing CTCL is challenging and requires a multidisciplinary approach involving dermatologists, pathologists, hematologists, and radiotherapists. The CUTALLO trial, the only prospective, randomized study in this field, demonstrated a benefit in PFS and quality of life but did not show a survival advantage. There is a notable lack of real-world data regarding the timing, treatment sequencing and efficacy of allogeneic transplants in MF and SS. Aim Describe real-world patterns of allo-HSCT, including transplant timing and clinical outcomes, in patients with advanced MF/SS treated at three Brazilian transplant centers. Methods We compiled data from patients aged ≥18 y/o diagnosed with MF/SS submitted to allogenic transplant. Clinical information included coded patient, gender, age, date of diagnostic, sites of disease, TNM stage, number of lines of therapy and its response. Allogenic transplant characteristics and outcomes were also described. Treatment outcome was determined by OS and PFS. REDcap Platform (by Vanderbilt) has been used to collect and store data and for descriptive analysis the IBM-SPSS version 24 was applied. Kaplan-Meier method estimated the OS, whereas Log-Rank tests to compare its curves. Results In this descriptive analysis, we evaluated 12 patients who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) for advanced mycosis fungoides (MF) or Sézary syndrome (SS). The cohort comprised six women and six men, with a median age of 47 years (range, 22–62). Patients were heavily pretreated, having received a median of three prior lines of therapy (range, 1–7). Before transplantation, most had been exposed to low- or intermediate-intensity therapies, including interferon (50%), methotrexate (33%), brentuximab vedotin (42%), and total skin electron beam therapy (75%), while six patients (50%) had also received multi-agent chemotherapy. The median time from diagnosis to allo-HSCT was 23.3 months (range, 6.2–304.4), underscoring the variability in the timing of transplantation in real-world clinical practice. After a median follow-up of 18.0 months (range, 1.8–88.9), six patients (50%) remained in complete remission, six (50%) experienced disease progression, and four (33%) died. Median progression-free survival (PFS) was 20.2 months, with estimated PFS rates of 64.2% and 42.8% at 12 and 24 months, respectively. Median overall survival (OS) was 34.1 months, with estimated OS rates of 91.7%, 65.5%, and 43.7% at 12, 24, and 36 months, respectively. Conclusion Allogeneic HSCT remains an important therapeutic option for selected patients with advanced MF/SS and offers the possibility of durable long-term disease control. Despite advanced-stage disease and extensive pretreatment, half of the patients in our cohort achieved durable complete remission, demonstrating that sustained disease control remains achievable even in heavily pretreated patients. The median interval of 23.3 months from diagnosis to allo-HSCT highlights the variability in the timing of transplantation in real-world clinical practice and reinforces the need to better define the optimal timing of transplantation.
Language: English
Subfield: Dermatology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7223098451