Advances in Lymphoma
Transcript: Removing TBI from PTCL conditioning
Dr Francine Foss
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So for patients undergoing allogeneic transplant with aggressive T-cell lymphomas, the standard of care is to use a regimen that's non-myeloablative or has reduced intensity, mainly because the patients are basically older and some of them have comorbidities, but there's no consensus as to whether or not the inclusion of total body radiation in the regimen has any impact on the outcome. So I think the issue with this is that this is a retrospective analysis and there are small numbers of patients, 28 and 22, with respect to TBI and non-TBI respectively. They also represent different histologies and different IPI scores or risk factors. So I think that that's one major consideration when you look at this type of data. There are some patients who go into the transplant in complete remission, others go into the transplant with residual disease. In the case of the latter patients, perhaps the radiation has some benefit. So I think in order to answer the question for sure about the role of total body radiation, we really need to have a prospective trial looking at a more homogeneous group of patients.
Now, that's gonna be a difficult thing to do in aggressive T-cell lymphoma, given that it's so rare. There is some data from our institution where we use TBI as a standard and we show that our outcomes for patients with persistent disease at the time of transplant are actually very good. Again, that's single centred data and I think what we wanna do is try to look collectively across a number of centres that are still using TBI to really answer this question.
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