Comparison The role of auto-HSCT and allo-HSCT in extranodal natural killer/T cell lymphoma

Abstract

Abstract Objectives: As advanced-stage or relapsed/refractory (R/R) extranodal NK/T-cell lymphoma (ENKL)is highly progressive and sometimes multi-drug resistant, there is so far no standard management for them. Autologous hematopoietic stem cell transplantation (auto-HSCT) and allogeneic hematopoietic stem cell transplantation (allo-HSCT) are considered optional consolidation therapy for advanced-stage or R/R ENKL, but their applications to ENKL is currently limited. Methods: We collected cases of advanced-stage or R/R ENKL patients with auto- or allo-HSCT, including 17 newly diagnosed patients from our hospital, (15 with auto-HSCT, 2 with allo-HSCT), and 489 cases from literatures in recent 21 years, (331 with auto-HSCT, 158 with allo-HSCT). We summarized the patients’ characteristics and conducted survival analysis of the 17 cases from our hospital, and analyzed the potential benefits of auto- and allo-HSCT to ENKL patients according to the reported information in literatures. Results: Of the 17 cases of our hospital, with the median follow-up time of 36 month (range: 10~93 months), 1 relapsed but recovered, 1 relapsed and died of disease progression, and 1 died of severe pneumonia respectively, the others were CR and survived for more than 20 months. Of the cases from literatures, in the patients with auto-HSCT (average follow-up time 43.3 months), 127 (38.4%) relapsed, 106 (32.0%) died (treatment-related mortality TRM=14.2%), and in the patients with allo-HSCT (average follow-up time 31.0 months), 58 (36.7%) relapsed, 82 (51.9%) died (TRM=18.3%). Conclusions: Auto-HSCT and allo-HSCT are indeed options to advanced-stage or R/R ENKL, but further studies are still required with more strict disease management.