Navigating Transplant Strategy for Partial Responders in T-Cell Lymphoma

In an interview with CancerNetwork® at the 2026 Society of Hematologic Oncology (SOHO) Annual Meeting in Houston, Texas, Mary Jo Lechowicz, MD, an associate professor of hematology and medical oncology at Winship Cancer Institute of Emory University in Atlanta, Georgia, addressed how multidisciplinary care teams should approach transplant strategy when patients with T-cell lymphoma achieve only a partial response following induction therapy.

Lechowicz explained that while retrospective data demonstrate that patients with partial responses can derive benefit from autologous HSCT, given that autologous transplant is fundamentally dependent on chemo-responsiveness, depth of remission predicts longer-term progression-free survival in both autologous and allogeneic settings. Rather than a universal threshold mandating a switch to allogeneic HSCT, the decision remains patient specific and is shaped by allogeneic eligibility, toxicity considerations, and the clinical concern that a partial remission raises for primary refractory or early relapse disease. For patients in the latter category, she recommended initiating donor typing early to preserve the option.

Transcript:

CancerNetwork: In light of emerging data suggesting that pre-transplant depth of response strongly correlates with post-transplant relapse-free survival, how should multidisciplinary care teams approach patients who achieve only a partial response following induction? Is there a clear threshold at which transition from an autologous to an allogeneic HSCT strategy is mandatory?

Lechowicz: It is always going to be patient specific in terms of what is mandatory and who [can] have an allogeneic transplant. While there are retrospective data showing that patients with a partial response can have some benefit from an autologous transplant, we know that autologous transplant is based on chemo-responsiveness. For both autologous and allogeneic transplant, depth of remission portends toward longer-term progression-free survival.

The other thing to consider is toxicity. There are patients who may not be allogeneic eligible, and we sometimes consider an autologous transplant. However, if a patient has a partial remission, we become concerned about primary refractory disease or early relapse; those are the patients we would type and evaluate for an allogeneic transplant option.

Reference

Lechowicz MJ. Auto versus allo transplant for T-cell lymphomas. Presented at: 2026 Society of Hematologic Oncology (SOHO) Annual Meeting; September 9-12