E-ISSN: 1308-5263
Allogeneic Hematopoietic Stem Cell Transplantation in Extranodal Natural Killer/T-cell Lymphoma [Turk J Hematol]
Turk J Hematol. 2021; 38(2): 126-137 | DOI: 10.4274/tjh.galenos.2021.2020.0438  

Allogeneic Hematopoietic Stem Cell Transplantation in Extranodal Natural Killer/T-cell Lymphoma

Peng Yin1, Yi-ying Xiong1, Li-xia Zhang1, Jing Wang1, Hong-bin Zhang1, Qing Xiao1, Shu-liang Guo2
1First Affiliated Hospital of Chongqing Medical University, Department of Hematology, Chongqing, China
2First Affiliated Hospital of Chongqing Medical University, Department of Respiratory Medicine, Chongqing, China

Objective: Extranodal NK/T-cell lymphoma (ENKL) is aggressive and resistant to chemotherapy and radiotherapy. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially curative treatment for high-risk lymphomas owing to its associated graft-versus-lymphoma (GVL) effect. However, its application to ENKL is limited. We aim to summarize the characteristics of allo-HSCT for ENKL and, more importantly, evaluate whether allo-HSCT could offer any benefits for ENKL
Materials and Methods: A systematic review and data analysis were performed to evaluate the performance of allo-HSCT in the treatment of ENKL using studies obtained from PubMed, Medline, and Embase from January 2000 to December 2019 in the English language.
Results: A total of 136 cases from 17 eligible publications were included in this study. It was found that after allo-HSCT, with an average follow-up time of 34 months (range: 1-121 months), 37.5% (52) of 136 patients had acute graft-versus-host disease (GVHD) and 31.6% (43) had chronic GVHD. Furthermore, 35.3% (48) of the patients were reported to have relapsed, but 2 of those relapsed only locally and achieved complete remission (CR) again with additional irradiation, chemotherapy, and donor lymphocyte infusions for one and rapid tapering and discontinuation of cyclosporine for the other, earning more than one year of extra survival. Finally, of the 136 patients, 51.5% (70) died because of primary disease progression (42.9%), infection (20.0%), GVHD (11.4%), organ failure (7.1%), hemorrhage (4.3%), and other causes (not specified/unknown) (14.3%).
Conclusion: Allo-HSCT may be a treatment option for advanced or relapsed/refractory ENKL, but its role still requires more rigorous future studies.

Keywords: Extranodal NK/T-cell lymphoma, Chemotherapy, Radiotherapy, Allogeneic hematopoietic stem cell transplantation


Ekstranodal Doğal Öldürücü/T-hücreli Lenfomada Allojeneik Hematopoetik Hücre Transplantasyonu

Peng Yin1, Yi-ying Xiong1, Li-xia Zhang1, Jing Wang1, Hong-bin Zhang1, Qing Xiao1, Shu-liang Guo2
1First Affiliated Hospital of Chongqing Medical University, Department of Hematology, Chongqing, China
2First Affiliated Hospital of Chongqing Medical University, Department of Respiratory Medicine, Chongqing, China

Amaç: Ekstranodal NK/T-hücreli lenfoma (ENKL) agresiftir ve kemoterapi ve radyoterapiye dirençlidir. Allojenik hematopoetik kök hücre transplantasyonu (allo-HSCT), ilişkili graft-lenfoma (GVL) etkisi nedeniyle, yüksek riskli lenfomalara yönelik potansiyel olarak iyileştirici bir tedavidir. Bununla birlikte, ENKL’ye uygulanması sınırlıdır. Bu çalışmada ENKL için allo-HSCT’nin/AHKHN’nin özelliklerini özetlemeyi ve daha da önemlisi allo-HSCT’nin ENK için herhangi bir fayda sağlayıp sağlamayacağını değerlendirmeyi amaçlıyoruz.
Gereç ve Yöntem: Ocak 2000’den Aralık 2019’a kadar İngilizce dilinde PubMed, Medline ve Embase literatürleri kullanılarak allo-HSCT’nin ENKL’ye performansını değerlendirmek için sistematik bir inceleme ve veri analizi gerçekleştirildi.
Bulgular: Bu çalışmaya 17 uygun yayından toplam 136 olgu dahil edildi. 1) allo-HSCT’den sonra, 34 aylık ortalama takip süresine göre (aralık: 1-121 ay), 136 hastanın %37,5’inde (52) akut graft-versushost hastalığı (GVHD), %31,6’sında (43) kronik GVHD vardı; 2) rapor edildiğinde, hastaların %35,3’ünde (48) relaps vardı, ancak bunlardan ikisi sadece lokal olarak nüks etti ve bunlardan birine ek ışınlama, kemoterapi, donör lenfosit infüzyonu ile tekrar tam remisyon (CR) sağladı, diğerine siklosporinin hızlı azaltılması ve kesilmesi bir yıldan fazla ekstra sağkalım kazandırdı; 3) 136 hastanın %51,5’i (70) primer hastalık ilerlemesi (%42,9), enfeksiyon (%20,0), GVHD (%11,4), organ yetmezliği (%7,1), kanama (%4,3) ve diğerleri (belirtilmedi/bilinmiyor) (%14,3) nedeniyle öldü.
Sonuç: Allo-HSCT, ilerlemiş veya nükseden/refrakter ENKL için bir tedavi seçeneği olabilir, ancak rolü hala daha titiz gelecek çalışmaları gerektirmektedir.

Anahtar Kelimeler: Ekstranodal NK/T-hücreli lenfoma, Kemoterapi, Radyoterapi, Allojeneik hematopoetik kök hücre nakli


Peng Yin, Yi-ying Xiong, Li-xia Zhang, Jing Wang, Hong-bin Zhang, Qing Xiao, Shu-liang Guo. Allogeneic Hematopoietic Stem Cell Transplantation in Extranodal Natural Killer/T-cell Lymphoma. Turk J Hematol. 2021; 38(2): 126-137

Corresponding Author: Peng Yin, China


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