Prognostic factors and treatment outcomes of allogeneic stem cell transplantation in lymphoid malignancy

TL;DR

This study identifies post-transplant complete remission as a key factor for better survival in patients undergoing stem cell transplants for lymphoid cancers.

Contribution

The study identifies post-transplant complete remission as an independent predictor of improved survival after allogeneic stem cell transplantation for lymphoid malignancies.

Findings

Median progression-free survival was 27.4 months and overall survival was 30.6 months.

Post-transplant complete remission was the only independent predictor of improved survival in multivariate analysis.

HLA matching was associated with better outcomes in specific lymphoma subtypes like B-cell and NK/T-cell lymphoma.

Abstract

Allogeneic stem cell transplantation (allo-SCT) is a potentially curative treatment option for patients with relapsed or refractory lymphoid malignancies. However, the prognostic factors influencing survival outcomes in these patients remain poorly defined. This study aimed to evaluate the clinical variables associated with progression-free survival (PFS) and overall survival (OS) in patients undergoing allo-SCT for lymphoid malignancies.

We analyzed 58 patients who underwent allo-SCT for lymphoid malignancies, including B-cell lymphoma (BCL, n = 20), Hodgkin lymphoma (n = 3), multiple myeloma (n = 9), natural killer/T-cell lymphoma (NK/TCL, n = 4), and T-cell lymphoma (TCL, n = 22). Clinical factors such as HLA matching and post-transplant response status were assessed for their association with survival outcomes using univariate and multivariate analyses.

The median PFS and OS were 27.4 months and 30.6 months, respectively. In univariate analysis, both HLA matching and complete remission (CR) status after transplantation were associated with superior PFS and OS. However, multivariate analysis identified only post-transplant CR as an independent predictor of improved survival. Subgroup analysis revealed that HLA matching was significantly associated with better PFS in patients with BCL and NK/TCL, and with better OS only in BCL. Post-transplant CR was consistently associated with improved PFS and OS across BCL, NK/TCL, and TCL subtypes.

Post-transplant response is a key prognostic factor influencing survival in allo-SCT for lymphoid malignancies. Achieving complete remission after transplantation may help guide post-SCT management and risk-adapted therapeutic strategies.

The online version contains supplementary material available at 10.1007/s44313-025-00060-y.

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