Autologous stem cell transplantation in major T‐cell lymphoma entities: An analysis by the EBMT Lymphoma Working Party

Abstract Autologous stem cell transplantation (auto‐SCT) is an established treatment for peripheral T‐cell lymphoma (PTCL) to consolidate first remission and for patients with relapsed/refractory (r/r) disease. We aimed to examine the outcomes of patients with PTCL NOS, AITL, and ALK‐negative ALCL undergoing auto‐SCT between 2010 and 2022 and reported to EBMT. Adult patients with major T‐cell entities who had received auto‐SCT either up‐front or for r/r disease were included. 2082 patients underwent up‐front and 1249 salvage auto‐SCT. Three‐year progression‐free (PFS) and overall survival (OS) after up‐front auto‐SCT were 55.2% and 73.1%. For r/r patients, 3‐year PFS and OS were 42.6% and 59.5%. In multivariate analysis, male patients, histology other than ALK‐negative ALCL, non‐CR, and higher age at auto‐SCT showed significantly lower PFS and OS after both, up‐front and salvage auto‐SCT, mostly reflecting the higher relapse incidence for these patients. Major outcomes did not significantly change when the analyses were restricted to the patients with PET‐based response at auto‐SCT ( n = 2062). Auto‐SCT demonstrated excellent outcomes when used up‐front and surprisingly good results in salvage settings. Patients with ALK‐negative ALCL survived significantly better than patients with PTCL NOS or AITL. Male gender, higher age, and non‐CR at auto‐SCT were associated with poor outcomes. Overall, auto‐SCT is a valid treatment option in T‐cell lymphoma where targeted therapies still play a limited role.