According to a recent article published in the Journal of Clinical Oncology, an allogeneic stem cell transplant appears effective in the treatment of cutaneous T-cell lymphomas that have stopped responding to standard therapies.

Lymphomas are a group of cancers that affect cells of the immune system, referred to as B-cells or T-cells. B-cell lymphomas are the most common and also receive more research attention. T-cell lymphomas tend to be more aggressive.
When patients with T-cell lymphomas stop responding to standard therapies (refractory lymphoma), effective treatment options are limited.

An allogeneic stem cell transplant involves the use of high doses of chemotherapy, with or without radiation therapy, followed by an infusion of a donor’s stem cells. While the higher doses of therapy are used to kill more cancer cells than conventional doses, they also damage healthy cells and tissues. To replenish cells damaged during therapy, donor stem cells (immature blood cells) are collected prior to therapy and infused following therapy.

Even though an allogeneic stem cell transplant is associated with high rates of severe side effects, as well as mortality, it is often the only curative option in certain types of cancers. Researchers are now evaluating the use of more conventional doses of therapy prior to stem cell infusion, referred to as a non-myeloablative stem cell transplant. Anti-cancer effects are augmented with infusion of a donor’s stem cells: These cells often recognize the patient’s cancer cells as “foreign” and mount an attack against them. Unfortunately, they may also recognize a patient’s healthy tissues as foreign, resulting in a condition referred to as “graft-versus-host-disease”, or GVHD. Allogeneic stem cell transplant requires that a balance is maintained between producing a cure and keeping side effects acceptable.

Researchers from the City of Hope National Medical Center recently analyzed data from eight patients with cutaneous T-cell lymphomas, Sezary syndrome, and mycoses fungoides. These types of lymphomas affect the skin of patients. The data included patients who had stopped responding to several prior therapies. Four patients underwent an allogeneic stem cell transplant including high doses of therapy, and four underwent non-myeloablative allogeneic stem cell transplants.

All patients achieved a complete disappearance of detectable cancer.
Two patients ultimately died from complications associated with treatment. At a follow-up of 56 months, the remaining six patients are alive and cancer-free. Patients treated with the non-myeloablative transplants suffered from fewer side effects.

The researchers concluded that allogeneic stem cell transplants result in long-term overall and cancer-free survivals in patients with refractory, cutaneous T-cell lymphomas. Patients with refractory, cutaneous T-cell lymphomas may wish to speak with their physician regarding their individual risks and benefits of undergoing an allogeneic stem cell transplant or the participation in a clinical trial further evaluating stem cell transplants or other promising therapeutic approaches.

Source: Cancer Consultants []