Evaluating Long-Term Efficacy and Safety of AlloSCT Among Patients With Peripheral T-Cell Lymphoma

Long-Term Follow-Up Results from the AATT Study

According to 7-year follow-up results from the Autologous or Allogeneic Transplantation in Patients With Peripheral T-Cell Lymphoma (AATT) study, while allogeneic stem cell transplantation (alloSCT) is the preferred treatment for younger, transplant-eligible patients with relapsed/refractory (R/R) peripheral T-cell lymphoma (PTCL), it is currently not recommended as part of first line consolidation.

“Primary analysis of the phase 3 randomized AATT study showed that younger patients with PTCL consolidated with autologous or allogeneic transplantation had similar event-free survival (EFS) and overall survival (OS),” stated lead study author Olivier Tournilhac, MD, University Leipzig, Leipzig, Germany, and coauthors.

Following up on this primary analysis, investigators report long-term results of 7-year EFS of patients randomly assigned to alloSCT was 38% (95% confidence interval [CI], 25 to 52) compared with 34% (95% CI, 22 to 47) for patients who were randomly assigned to autologous transplantation of hematopoietic stem cells (autoSCT). The OS was 55% (95% CI, 41 to 69) and 61% (95% CI, 47 to 74). Among the trial participants who were undergoing alloSCT (n = 26) or autoSCT (n = 41), the cumulative progression/relapse rate was 8% (95% CI, 0 to 19) and 55% (95% CI, 35 to 74).

Additionally, the reported nonrelapse mortality (NRM) was 31% (95% CI, 13 to 49) and 3% (95% CI, 0 to 8) after alloSCT and autoSCT, respectively. Study authors noted 15 of 30 patients with early progression and 11 of 20 patients with progression/relapse after autoSCT received alloSCT. Further data noted 7-year OS following salvage alloSCT was 61% (95% CI, 47 to 74); NRM was 23% (95% CI, 6 to 40).

“AlloSCT is the treatment of choice for younger, transplant-eligible patients with relapsed/refractory PTCL. AlloSCT is currently not recommended as part of first-line consolidation,” concluded Dr Tournilhac and colleagues.

Investigators added this follow-up highlights the “strong graft versus lymphoma effect of alloSCT independent of the timing of transplantation” and that survival of patients who were unable to undergo transplantation was poor.

Source:

Tournilhac O, Altmann B, Friedrichs B, et al. Long-term follow-up of the prospective randomized AATT study (autologous or allogeneic transplantation in patients with peripheral T-cell lymphoma). J Clin Oncol. Published online September 13, 2024. doi: 10.1200/JCO.24.00554