The Role of Allogeneic Stem Cell Transplantation in Adult Patients With Peripheral T-Cell Lymphoma: A Systematic Review and Meta-Analysis.

Abstract

Objectives: Peripheral T-cell lymphomas (PTCLs) are rare, aggressive non-Hodgkin lymphomas with limited treatment options and poor prognosis, especially upon relapse. Both autologous and allogeneic stem cell transplants have been used, although allogeneic transplantation is preferred for resistant cases. This systematic review and meta-analysis aim to clarify the impact of allogeneic transplantation on survival and treatment outcomes in PTCL patients.

Methods: We systematically searched the electronic databases PubMed, Scopus, and Web of Science from each database's inception to September 2024. Following the PRISMA guidelines, we included adult patients with PTCL undergoing allogeneic hematopoietic stem cell transplantation (Allo-HSCT). We used proportional meta-analysis by executing a random-effects model (DerSimonian-Laird), with data transformation via the Freeman-Tukey method. Heterogeneity was assessed through I² and prediction intervals. We evaluated the risk of bias with the Methodological Index for Non-Randomized Studies (MINORS) tool and assessed evidence quality using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. All analyses were performed using the R software package.

Results: Our search retrieved 448 articles after first scanning and removing the duplicates. A total of 112 titles were eligible for full-text screening. Finally, 10 studies were included with a total of 1586 patients. The 1-year overall survival (OS) proportion of 63.4% (95% confidence interval [CI] = 56.6% to 70%) across 9 studies with 1555 observations and 1077 events. The 1-year progression-free survival (PFS) proportion of 56.1% (95% CI = 51.1% to 61.1%) across 7 studies, with 1224 observations and 711 events. The 1-year non-relapse mortality (NRM) proportion of 22.3% (95% CI = 15.4% to 29.9%) across 6 studies with 1379 observations and 243 events recorded.

Conclusions: This systemic review supports the use of allogeneic hematopoietic stem cell transplantation for patients with PTCL; however, further research is needed to confirm its various benefits and limitations as a possible innovation in the field.