A comprehensive analysis of the role of stem cell transplantation in mantle cell lymphoma: real-world data from the Korean Society of Blood and Marrow Transplantation registry: Stem cell transplantation outcomes in mantle cell lymphoma

TL;DR

This study uses real-world data to compare the effectiveness of autologous and allogeneic stem cell transplants in treating mantle cell lymphoma.

Contribution

The study provides real-world evidence on stem cell transplantation outcomes in MCL using a Korean registry.

Findings

Autologous and allogeneic SCT showed similar 3-year progression-free and overall survival rates in MCL patients.

Allogeneic transplants with HLA-matched donors improved outcomes for refractory MCL patients.

Auto-SCT was more beneficial for patients in remission after salvage therapy.

Abstract

Stem cell transplantation (SCT) has historically played a major role in the long-term remission of mantle cell lymphoma (MCL), an incurable hematological malignancy. Using data from the Korean Society of Bone and Marrow Transplantation registry, we retrospectively analyzed the role of autologous (auto) and allogeneic (allo) SCT in long-term MCL survival.

This study analyzed data from 188 patients (age ≥ 19 years at the time of transplantation) who underwent a transplant for MCL from 2011 to 2020. Progression-free survival (PFS) was defined as the time from transplantation to disease progression, relapse, or death from any cause. Overall survival (OS) was defined as the time from transplantation to death from any cause or the last follow-up.

In total, 109 patients underwent consolidative SCT after first-line chemotherapy. The 3-year PFS and OS rates were 65.4% and 78.5%, respectively, in the auto-SCT group, and 66.7% and 71.4%, respectively, in the allo-SCT group. The PFS and OS did not differ significantly between the auto- and allo-SCT groups. As part of salvage treatment, 52 patients with relapsed or refractory disease underwent auto- or allo-SCT. Patients who underwent auto-SCT with complete remission/partial remission status reported better outcomes. In patients with refractory status, allogeneic transplantation using human leukocyte antigen (HLA) fully matched donors was a significantly favorable factor for PFS and OS.

The long-term survival of patients who underwent consolidative transplantation was similar to that reported in previous studies. Auto-SCT may be beneficial in patients who respond to salvage therapy, whereas allo-SCT with HLA-matched donors may be an alternative for patients with refractory disease.

The online version contains supplementary material available at 10.1007/s44313-025-00092-4.

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