Role of haematopoietic stem cell transplantation in peripheral T-Cell lymphoma.

Abstract

Peripheral T-cell lymphomas (PTCLs) are distinct pathological entities with clinical advancements lagging behind their B-cell lymphoma counterpart. Frequently aggressive in their clinical behaviour, clinicians are constantly challenged with low complete remission rates, early relapses and failure to achieve long-term responses despite aggressive first-line chemotherapy, resulting in poor overall survival in the majority of patients. There is currently no consensus regarding the optimal therapy for PTCL and treatment approaches are mainly derived from prospective phase II studies, registry data and retrospective studies. Despite its biological heterogeneity, a less than satisfactory "one-size-fits-all" approach has been adopted to date. Although its role remains controversial, for many years, haematopoietic stem cell transplantation has been adopted by clinicians with the aim of overcoming poor outcomes by consolidating responses. In this review, we aim to define the role of both autologous and allogeneic stem cell transplantation in PTCL in both frontline and salvage settings, especially in the context of recent advancements in this field. The electronic database MEDLINE (1998–2020) was searched to review the role of HSCT in PTCLs. Titles, keywords and abstracts of citations were reviewed and full copies of potentially suitable articles were assessed further. The following search strategy was used: ‘bone marrow transplantation’ OR ‘hematopoietic stem cell transplantation’ OR ‘stem cell transplantation’ AND ‘lymphoma, t-cell’ OR ‘t-cell, peripheral’ with limits to adults, English language AND Humans. On the basis of currently available data, HSCT remains an important therapeutic modality in the management of PTCLs in both the frontline and salvage settings, however the lack of good quality randomized data to guide management has resulted in lack of consensus and occasionally conflicting recommendations in the literature. The rapidly evolving changes in the diagnostic and therapeutic landscape, will necessitate an ongoing evaluation of the role of HSCT in the management of these heterogeneous diseases.