Role of stem cell transplantation in treatment of primary cutaneous T-cell lymphoma

Background. Within the heterogeneous group of cutaneous T-cell lymphomas (CTCL) the therapeutic options for advanced and progressive forms are particularly limited. Objective. The therapeutic value of hematopoietic stem cell transplantation in CTCL was analyzed. Material and methods. A literature search using the keywords "hematopoietic stem cell transplantation" and "cutaneous T-cell lymphoma" was performed in PubMed. Studies between 1990 and 2017 were taken into account. The studies identified were analyzed for relevance and being up to date. Results. After reviewing the currently available literature no prospective randomized studies were found. Wu et al. showed a superiority of allogeneic transplantation in a comparison of autologous and allogeneic stem cell transplantation for cutaneous lymphoma. The graft-versus-lymphoma effect plays a significant role in a prolonged progression-free survival after allogeneic transplantation. By using a non-myeloablative conditioning regimen, stem cell transplantation can also be an option for elderly patients. The most extensive long-term data after allogeneic stem cell transplantation were reported by Duarte et al. in 2014. Conclusion. Autologous stem cell transplantation does not currently represent a therapeutic option, whereas allogeneic stem cell transplantation for advanced cutaneous T-cell lymphoma, using a non-myeloablative conditioning scheme, does represent a therapeutic option. However, there is no consensus on the appropriate patients and the right timing. Morbidity and mortality of complications should be taken into account. Thus, this procedure is currently subject to an individual case decision.