BEAM-alemtuzumab followed by allogeneic SCT for the treatment of relapsed or refractory T-NHL.

8552 Mature T/NK-cell-Lymphomas represent highly malignant and in Western countries rare tumors of lymphoid origin. For patients with relapsed or refractory T-NHL the prognosis is grim and no standard treatment strategy exists. Ten patients (age: 11 to 59 y) with relapsed or refractory T/NK-NHL were treated with allogeneic stem cell transplantation (SCT) after 1 to 2 cycles of CLAEG (cladribine, cytarabine, etoposide and G-CSF) induction therapy followed by conditioning with BEAM (carmustine, cytarabine, etoposide, melphalan) combined with alemtuzumab (Campath-1H). The following subtypes were included: 5 peripheral T-NHL (NOS), 2 angioimmunoblastic, 1 ALK negative ALCL, 1 extranodal NK/nasal type and 1 enteropathy-type T-NHL. All patients had at least 2 different treatment regimens previously. After induction chemotherapy with CLAEG, one patient achieved a CR, 6 PR and 3 SD. 7 patients received peripheral blood stem cells from HLA-identical unrelated donors and 2 from matched sibling donors. 1 patient received bone marrow from an one-allele mismatched unrelated donor. Engraftment was rapid and the treatment well tolerated. There were 4 cases of grade IV mucositis, 2 cases of sepsis in neutropenia, and 1 case of grade IV liver toxicity. One patient died from sepsis on d + 45. Prophylaxis for graft-versus-host disease (GvHD) consisted of cyclosporine A and MTX or mycophenolate mofetil. No grade III or IV acute GvHD was seen and only 3 patients presented with grade II GvHD. Two patients experienced limited chronic GvHD. Asymptomatic CMV reactivation was found in 4 cases and all were treated successfully. Late infections occurred in four patients, including CMV infection, viral enteritis, aspergillosis and streptococcal sepsis. 9 patients achieved a CR after allogeneic SCT. Currently, 3 patients relapsed: two of them died due to disease-related complications, one is receiving DLI. Another patient died in CR on day + 233 due to aspiration pneumonia caused by non-malignant bowel stenosis. All other patients remained in CR for up to 27+ months. Allogeneic SCT with this strategy shows a surprisingly good outcome in a group of T/NK-NHL patients with an otherwise very poor prognosis and seems to be a promising therapeutic option for these patients. No significant financial relationships to disclose.