{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T21:17:43Z","timestamp":1790198263925,"version":"4.1.0"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T00:00:00Z","timestamp":1739404800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T00:00:00Z","timestamp":1739404800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Bone Marrow Transplant"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Allogeneic hematopoietic cell transplantation (alloHCT) is an effective treatment for patients with relapsed\/refractory peripheral T-cell lymphoma (PTCL), but the contribution of the conditioning regimen is still unclear. Here we present a retrospective single-center study using conditioning with intermediate-dose total body irradiation (TBI) and fludarabine for alloHCT in PTCL. Forty-seven patients underwent alloHCT for PTCL between 2010 and 2023 after conditioning with fludarabine and intermediate-dose TBI (8\u2009Gy in 87% of the cases). In most patients alloHCT was administered as part of second-line therapy, in 22 (47%) patients after having been primary refractory, and 21 (45%) of the patients were chemoresistant at alloHCT. With a median follow-up of 5.5 years, 5-year progression-free survival (PFS), overall survival, relapse incidence, and non-relapse mortality were 61%, 65%, 24%, and 15%, respectively. The 5-year PFS of patients transplanted with stable disease and progressive disease was 57% and 26%, respectively. Of 11 relapses, only 2 (18%) occurred beyond 6 months post transplant, and no relapse was observed after onset of chronic graft-versus-host disease. AlloHCT with intermediate-dose TBI\/fludarabine conditioning is associated with a favorable toxicity\/efficacy profile and can provide durable survival in a substantial fraction of patients with PTCL including those with poorly controlled disease at transplant.<\/jats:p>","DOI":"10.1038\/s41409-025-02522-4","type":"journal-article","created":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T14:20:04Z","timestamp":1739456404000},"page":"581-586","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Intermediate-dose TBI\/fludarabine conditioning for allogeneic hematopoietic cell transplantation in patients with peripheral T-cell lymphoma"],"prefix":"10.1038","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1667-4109","authenticated-orcid":false,"given":"Isabelle","family":"Kr\u00e4mer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laila","family":"K\u00f6nig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0387-1640","authenticated-orcid":false,"given":"Thomas","family":"Luft","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1917-6746","authenticated-orcid":false,"given":"Ute","family":"Hegenbart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4853-5579","authenticated-orcid":false,"given":"Stefan","family":"Sch\u00f6nland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja","family":"Eichkorn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Stadtherr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8331-4395","authenticated-orcid":false,"given":"Lorenz","family":"Selberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten","family":"M\u00fcller-Tidow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7429-8570","authenticated-orcid":false,"given":"Peter","family":"Dreger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,2,13]]},"reference":[{"key":"2522_CR1","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1182\/blood-2018-01-791335","volume":"132","author":"N Schmitz","year":"2018","unstructured":"Schmitz N, Lenz G, Stelljes M. Allogeneic hematopoietic stem cell transplantation (HSCT) for T-cell lymphomas. Blood. 2018;132:245\u201353.","journal-title":"Blood"},{"key":"2522_CR2","doi-asserted-by":"publisher","first-page":"1241","DOI":"10.1007\/s00277-018-3288-7","volume":"97","author":"S Rohlfing","year":"2018","unstructured":"Rohlfing S, Dietrich S, Witzens-Harig M, Hegenbart U, Sch\u00f6nland S, Luft T, et al. The impact of stem cell transplantation on the natural course of peripheral T-cell lymphoma: a real-world experience. Ann Hematol 2018;97:1241\u201350.","journal-title":"Ann Hematol"},{"key":"2522_CR3","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1038\/s41409-018-0360-9","volume":"54","author":"G Wulf","year":"2019","unstructured":"Wulf G, Hasenkamp J, Jung W, Wilhelm C, Held G, Nickelsen M, et al. Allogeneic stem cell transplantation for patients with relapsed or refractory T-cell lymphoma: efficacy of lymphoma-directed conditioning against advanced disease. Bone Marrow Transplant. 2019;54:877\u201384.","journal-title":"Bone Marrow Transplant"},{"key":"2522_CR4","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1038\/bmt.2015.280","volume":"51","author":"AC Mamez","year":"2016","unstructured":"Mamez AC, Levy V, Chevallier P, Blaise D, Vigouroux S, Xhaard A, et al. Effect of immune modulation in relapsed peripheral T-cell lymphomas after post-allogeneic stem cell transplantation: a study by the Societe Francaise de Greffe de Moelle et de Therapie Cellulaire (SFGM-TC). Bone Marrow Transplant. 2016;51:358\u201364.","journal-title":"Bone Marrow Transplant"},{"key":"2522_CR5","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1016\/j.jtct.2022.12.009","volume":"29","author":"CH Sterling","year":"2023","unstructured":"Sterling CH, Hughes MS, Tsai HL, Yarkony K, Fuchs EJ, Swinnen LJ, et al. Allogeneic blood or marrow transplantation with post-transplantation cyclophosphamide for peripheral T cell lymphoma: the importance of graft source. Transplant Cell Ther 2023;29:267.","journal-title":"Transplant Cell Ther"},{"key":"2522_CR6","doi-asserted-by":"publisher","first-page":"3788","DOI":"10.1200\/JCO.24.00554","volume":"42","author":"O Tournilhac","year":"2024","unstructured":"Tournilhac O, Altmann B, Friedrichs B, Bouabdallah K, Leclerc M, Cartron G, et al. Long-term follow-up of the prospective randomized AATT study (autologous or allogeneic transplantation in patients with peripheral T-cell lymphoma). J Clin Oncol. 2024;42:3788\u201394.","journal-title":"J Clin Oncol"},{"key":"2522_CR7","doi-asserted-by":"publisher","first-page":"1628","DOI":"10.1016\/j.bbmt.2009.07.004","volume":"15","author":"A Bacigalupo","year":"2009","unstructured":"Bacigalupo A, Ballen K, Rizzo D, Giralt S, Lazarus H, Ho V, et al. Defining the intensity of conditioning regimens: working definitions. Biol Blood Marrow Transplant. 2009;15:1628\u201333.","journal-title":"Biol Blood Marrow Transplant"},{"key":"2522_CR8","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1038\/bmt.2015.278","volume":"51","author":"X Cahu","year":"2016","unstructured":"Cahu X, Labopin M, Giebel S, Aljurf M, Kyrcz-Krzemien S, Soci\u00e9 G, et al. Impact of conditioning with TBI in adult patients with T-cell ALL who receive a myeloablative allogeneic stem cell transplantation: a report from the acute leukemia working party of EBMT. Bone Marrow Transplant. 2016;51:351\u20137.","journal-title":"Bone Marrow Transplant"},{"key":"2522_CR9","doi-asserted-by":"publisher","first-page":"139","DOI":"10.3324\/haematol.2016.145631","volume":"102","author":"S Giebel","year":"2017","unstructured":"Giebel S, Labopin M, Socie G, Beelen D, Browne P, Volin L, et al. Improving results of allogeneic hematopoietic cell transplantation for adults with acute lymphoblastic leukemia in first complete remission: an analysis from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation. Haematologica. 2017;102:139\u201349.","journal-title":"Haematologica"},{"key":"2522_CR10","first-page":"3314","volume":"106","author":"M Stelljes","year":"2005","unstructured":"Stelljes M, Bornhauser M, Kroger M, Beyer J, Sauerland MC, Heinecke A, et al. Conditioning with 8-Gy total body irradiation and fludarabine for allogeneic hematopoietic stem cell transplantation in acute myeloid leukemia. B. 2005;106:3314\u201321.","journal-title":"B"},{"key":"2522_CR11","doi-asserted-by":"publisher","first-page":"1035","DOI":"10.1016\/S1470-2045(12)70349-2","volume":"13","author":"M Bornhauser","year":"2012","unstructured":"Bornhauser M, Kienast J, Trenschel R, Burchert A, Hegenbart U, Stadler M, et al. Reduced-intensity conditioning versus standard conditioning before allogeneic haemopoietic cell transplantation in patients with acute myeloid leukaemia in first complete remission: a prospective, open-label randomised phase 3 trial. Lancet Oncol. 2012;13:1035\u201344.","journal-title":"Lancet Oncol"},{"key":"2522_CR12","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1007\/s00277-020-03952-4","volume":"99","author":"A Radujkovic","year":"2020","unstructured":"Radujkovic A, Hegenbart U, M\u00fcller-Tidow C, Herfarth K, Dreger P, Luft T. High leukemia-free survival after TBI-based conditioning and mycophenolate mofetil-containing immunosuppression in patients allografted for chronic myelomonocytic leukemia: a single-center experience. Ann Hematol 2020;99:855\u201366.","journal-title":"Ann Hematol"},{"key":"2522_CR13","doi-asserted-by":"publisher","first-page":"e812","DOI":"10.1097\/HS9.0000000000000812","volume":"7","author":"A Spyridonidis","year":"2023","unstructured":"Spyridonidis A, Labopin M, Savani B, Giebel S, Bug G, Sch\u00f6nland S, et al. Reduced 8-gray compared to standard 12-gray total body irradiation for allogeneic transplantation in first remission acute lymphoblastic leukemia: a study of the acute leukemia working party of the EBMT. Hemasphere. 2023;7:e812.","journal-title":"Hemasphere"},{"key":"2522_CR14","doi-asserted-by":"publisher","first-page":"708","DOI":"10.1111\/bjh.13202","volume":"168","author":"AM Petrich","year":"2015","unstructured":"Petrich AM, Helenowski IB, Bryan LJ, Rozell SA, Galamaga R, Nabhan C. Factors predicting survival in peripheral T-cell lymphoma in the USA: a population-based analysis of 8802 patients in the modern era. Br J Haematol 2015;168:708\u201318.","journal-title":"Br J Haematol"},{"key":"2522_CR15","first-page":"1163","volume":"109","author":"FO Meeuwes","year":"2024","unstructured":"Meeuwes FO, Brink M, Plattel W, van der Poel MWM, Kersten MJ, Wondergem M, et al. Outcome of combined modality treatment in first-line for stage I(E) peripheral T-cell lymphoma; a nationwide population-based cohort study from the Netherlands. Haematologica. 2024;109:1163\u201370.","journal-title":"Haematologica"},{"key":"2522_CR16","doi-asserted-by":"publisher","first-page":"100409","DOI":"10.1016\/j.xcrm.2021.100409","volume":"2","author":"L Orsatti","year":"2021","unstructured":"Orsatti L, Stiehl T, Dischinger K, Speziale R, Di Pasquale P, Monteagudo E, et al. Kynurenine pathway activation and deviation to anthranilic and kynurenic acid in fibrosing chronic graft-versus-host disease. Cell Rep. Med 2021;2:100409.","journal-title":"Cell Rep. Med"},{"key":"2522_CR17","doi-asserted-by":"publisher","first-page":"2375","DOI":"10.1182\/blood-2016-01-643569","volume":"127","author":"SH Swerdlow","year":"2016","unstructured":"Swerdlow SH, Campo E, Pileri SA, Harris NL, Stein H, Siebert R, et al. The 2016 revision of the World Health Organization (WHO) classification of lymphoid neoplasms. Blood. 2016;127:2375\u201390.","journal-title":"Blood"},{"key":"2522_CR18","doi-asserted-by":"publisher","first-page":"3059","DOI":"10.1200\/JCO.2013.54.8800","volume":"32","author":"BD Cheson","year":"2014","unstructured":"Cheson BD, Fisher RI, Barrington SF, Cavalli F, Schwartz LH, Zucca E, et al. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol 2014;32:3059\u201368.","journal-title":"J Clin Oncol"},{"key":"2522_CR19","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1038\/bmt.2015.305","volume":"51","author":"A Ruggeri","year":"2016","unstructured":"Ruggeri A, Labopin M, Ciceri F, Mohty M, Nagler A. Definition of GvHD-free, relapse-free survival for registry-based studies: an ALWP-EBMT analysis on patients with AML in remission. Bone Marrow Transplant. 2016;51:610\u20131.","journal-title":"Bone Marrow Transplant"},{"key":"2522_CR20","doi-asserted-by":"publisher","first-page":"2172","DOI":"10.1200\/JCO.2004.12.050","volume":"22","author":"P Corradini","year":"2004","unstructured":"Corradini P, Dodero A, Zallio F, Caracciolo D, Casini M, Bregni M, et al. Graft-versus-lymphoma effect in relapsed peripheral T-cell non-Hodgkin\u2019s lymphomas after reduced-intensity conditioning followed by allogeneic transplantation of hematopoietic cells. J Clin Oncol 2004;22:2172\u20136.","journal-title":"J Clin Oncol"},{"key":"2522_CR21","doi-asserted-by":"publisher","first-page":"1361","DOI":"10.1038\/s41375-022-01545-w","volume":"36","author":"K Kameda","year":"2022","unstructured":"Kameda K, Kako S, Kim SW, Usui Y, Kato K, Fukuda T, et al. Autologous or allogeneic hematopoietic cell transplantation for relapsed or refractory PTCL-NOS or AITL. Leukemia. 2022;36:1361\u201370.","journal-title":"Leukemia"},{"key":"2522_CR22","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1186\/s13045-020-00892-4","volume":"13","author":"AC Mamez","year":"2020","unstructured":"Mamez AC, Dupont A, Blaise D, Chevallier P, Forcade E, Ceballos P, et al. Allogeneic stem cell transplantation for peripheral T cell lymphomas: a retrospective study in 285 patients from the Societe Francophone de Greffe de Moelle et de Therapie Cellulaire (SFGM-TC). J Hematol Oncol 2020;13:56.","journal-title":"J Hematol Oncol"},{"key":"2522_CR23","doi-asserted-by":"publisher","first-page":"e161","DOI":"10.1016\/S2352-3026(18)30022-X","volume":"5","author":"F Fasslrinner","year":"2018","unstructured":"Fasslrinner F, Schetelig J, Burchert A, Kramer M, Trenschel R, Hegenbart U, et al. Long-term efficacy of reduced-intensity versus myeloablative conditioning before allogeneic haemopoietic cell transplantation in patients with acute myeloid leukaemia in first complete remission: retrospective follow-up of an open-label, randomised phase 3 trial. Lancet Haematol. 2018;5:e161\u2013e169.","journal-title":"Lancet Haematol"},{"key":"2522_CR24","first-page":"2646","volume":"137","author":"N Schmitz","year":"2021","unstructured":"Schmitz N, Truemper L, Bouabdallah K, Ziepert M, Leclerc M, Cartron G, et al. A randomized phase 3 trial of auto vs allo transplantation as part of first-line therapy in poor-risk peripheral T-NHL. Blood. 2021;137:2646\u201356.","journal-title":"Blood"},{"key":"2522_CR25","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1182\/hematology.2024000670","volume":"2024","author":"P Dreger","year":"2024","unstructured":"Dreger P, Schmitz N. The role of stem cell transplant (auto and allo) in PTCL and CTCL. Hematology Am Soc Hematol Educ Program. 2024;2024:69\u201377.","journal-title":"Hematology Am Soc Hematol Educ Program"},{"key":"2522_CR26","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1111\/bjh.18052","volume":"197","author":"M Savani","year":"2022","unstructured":"Savani M, Ahn KW, Chen Y, Ahmed S, Cashen AF, Shadman M, et al. Impact of conditioning regimen intensity on the outcomes of peripheral T-cell lymphoma, anaplastic large cell lymphoma and angioimmunoblastic T-cell lymphoma patients undergoing allogeneic transplant. Br J Haematol 2022;197:212\u201322.","journal-title":"Br J Haematol"},{"key":"2522_CR27","doi-asserted-by":"publisher","DOI":"10.1038\/bcj.2016.63","volume":"6","author":"M Wilhelm","year":"2016","unstructured":"Wilhelm M, Smetak M, Reimer P, Geissinger E, Ruediger T, Metzner B, et al. First-line therapy of peripheral T-cell lymphoma: extension and long-term follow-up of a study investigating the role of autologous stem cell transplantation. Blood Cancer J. 2016;6:e452.","journal-title":"Blood Cancer J"},{"key":"2522_CR28","doi-asserted-by":"publisher","first-page":"920","DOI":"10.1182\/bloodadvances.2021005899","volume":"8","author":"M Hamadani","year":"2022","unstructured":"Hamadani M, Ngoya M, Sureda A, Bashir Q, Litovich CA, Finel H, et al. Outcome of allogeneic transplantation for mature T-cell lymphomas: impact of donor source and disease characteristics. Blood Adv. 2022;8:920\u201330.","journal-title":"Blood Adv"},{"key":"2522_CR29","doi-asserted-by":"publisher","first-page":"686","DOI":"10.1038\/leu.2014.280","volume":"29","author":"A Tanase","year":"2015","unstructured":"Tanase A, Schmitz N, Stein H, Boumendil A, Finel H, Castagna L, et al. Allogeneic and autologous stem cell transplantation for hepatosplenic T cell lymphoma: A retrospective study of the EBMT Lymphoma Working Party. Leukemia. 2015;29:686\u20138.","journal-title":"Leukemia"},{"key":"2522_CR30","doi-asserted-by":"crossref","unstructured":"Karsten IE, Schmitz N, Fekom M, de Leval L, Finel H, Khvedelidze I et al. Hematopoietic Stem Cell Transplantation in Hepatosplenic T-Cell Lymphoma: A Retrospective Analysis of the EBMT Lymphoma Working Party [abstract]. Blood (ASH Annual Meeting Abstracts) 2024;399.","DOI":"10.1182\/blood-2024-210100"}],"container-title":["Bone Marrow Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41409-025-02522-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41409-025-02522-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41409-025-02522-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T10:28:06Z","timestamp":1746700086000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41409-025-02522-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,13]]},"references-count":30,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["2522"],"URL":"https:\/\/doi.org\/10.1038\/s41409-025-02522-4","relation":{},"ISSN":["0268-3369","1476-5365"],"issn-type":[{"value":"0268-3369","type":"print"},{"value":"1476-5365","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,13]]},"assertion":[{"value":"5 November 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 January 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 January 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 February 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Isabelle Kr\u00e4mer reports training and travel grant from Janssen-Cilag, SOBi; honoraria from AbbVie, Lilly, Incyte, AstraZeneca (partly to institution); congress participation fee from Lilly, SOBi. Ute Hegenbart reports honorarium for talks: Janssen, Pfizer, Alnylam, Akcea, Prothena, Astra Zeneca; financial support of congress participation: Janssen, Prothena, Pfizer; advisory boards: Pfizer, Prothena, Janssen, Alexion; financial sponsoring of Amyloidosis Registry: Janssen. Peter Dreger reports consultancy for AbbVie, AstraZeneca, Beigene, BMS, Gilead, Miltenyi (all to institution); speakers bureau for AbbVie, AstraZeneca, BeiGene, BMS, Gilead, Riemser, Roche (all to institution); research support from Riemser (all to institution); meeting attendance support from Beigene and Gilead; Participation on a Data Safety Monitoring Board for Novartis. The remaining authors declare no competing financial interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The study was performed in accordance with the Declaration of Helsinki. All patients provided written informed consent to data collection and scientific evaluation before admission to alloHCT. Data analysis was approved by the institutional review board (Ethics Committee of the Medical Faculty of Heidelberg University, S-200\/2010).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}}]}}