Dr. Goodman on the Role of Transplant in T-Cell Lymphoma

Aaron Goodman, MD, hematologist/oncologist and assistant professor of medicine at the University of California, San Diego, discusses the role of transplant in patients with T-cell lymphomas.

The role of autologous stem cell transplantation (ASCT) in patients with peripheral T-cell lymphoma (PTCL) who achieve complete remission1 (CR1) after CHOP or brentuximab vedotin (Adcetris) plus CHP is not well defined. In the phase III ECHELON-2 trial, patients who underwent transplant after achieving CR1 with brentuximab vedotin and CHP had a progression-free survival rate of approximately 70% to 80%. However, subset analyses are subject to biases. In the absence of randomized data, the discussion of whether to proceed with transplant should be had on an individualized basis, says Goodman.

Most phase II studies and retrospective studies show better outcomes with ASCT in CR1 compared with those who did not receive ASCT. However, the data may be biased because patients who can get a transplant are more fit and are going to do better, explains Goodman. Regarding anaplastic large-cell lymphomas that are ALK-positive, transplant is not recommended if patients achieve CR1, concludes Goodman.