Durable Clinical, Cytogenetic, and Molecular Remissions After Allogeneic Hematopoietic Cell Transplantation for Refractory Sezary Syndrome and Mycosis Fungoides

• DOI: 10.1200/jco.2005.02.774
• Publication Date: 2005-08-31T03:31:37Z
• Authors: Arturo Molina; Jasmine Zain; Daniel A. Arber; Maria Angelopolou; Margaret O’Donnell; Joyce Murata-Collins; Stephen J. Forman; Auayporn Nademanee
• Keywords: Refractory (planetary science)

Sezary syndrome (SS) and tumor-stage mycosis fungoides (MF) are generally incurable with currently available treatments. We conducted a retrospective study to evaluate the outcome of allogeneic hematopoietic stem-cell transplantation (HSCT) in this patient population.From August 1996 through October 2002, eight patients advanced MF/SS underwent HSCT at our institution. All were heavily pretreated, having failed median number seven prior therapies (range, five 12). Clonal T-cell populations peripheral blood or bone marrow detectable by polymerase chain reaction analyses receptor gamma-chain gene rearrangements six cytogenetics three patients. The conditioning regimen included total-body irradiation cyclophosphamide (n = 3), busulfan 1), reduced-intensity fludarabine melphalan 4). Allogeneic stem cells obtained from HLA-matched siblings 4) unrelated donors 4).All achieved complete clinical remission resolution molecular cytogenetic markers disease within 30 60 days after HSCT. Two died transplantation-related complications; graft-versus-host (GVHD; n 1) respiratory syncytial virus pneumonia 1). With follow-up 56 months, remain alive without evidence lymphoma.Our results suggest that both sibling can induce durable clinical, molecular, remissions cutaneous lymphoma is refractory standard therapies.