Hematopoietic stem cell transplantation

I'm your host, Dr. Salvia Jain, a hematologist oncologist at Massachusetts General Hospital in Boston, Massachusetts.

In today's episode, we'll be discussing the role of autologous and allogeneic stem cell transplantation in nodal peripheral T cell lymphoma subtypes.

We are very thrilled and excited to have Dr. Nora Binani, an associate professor of medicine at Mayo Clinic in Rochester, Minnesota, and Dr. Bhagirathi Dholaria, an associate professor of medicine also at Vanderbilt University in Nashville, Tennessee, join us today.

These are both T-cell lymphoma and bone marrow transplantation specialists, so they are really unique.

Maybe I'll start with Nora.

Nora, what patients with PTCL are likely to benefit from autologous stem cell transplantation, and what might their prerequisites be?

Good question, Salvia.

So I do offer consolidative autologous stem cell transplant in first remission to almost every patient.

And so did.

Another lot of treatment and they wanted to get to the point where they did a stem cell transplant, but you had to be free from the cancer first.

The first line they did for three months, which there was a lot more inpatient stays.

She had a kind of reaction to some of the medication.

2021.

She was technically cured of cancer.

Um, but because of that relapse, they do this stem cell transplant.

So she had her stem cells harvested.

Now, similar to Orin and Bev's story, my sister...

Rebecca is also currently going through a stem cell transplant.

I am her donor.

And so unlike Daniel, who had to wait six years since diagnosis to find a stem cell donor that was ethnically matched My sister's was right in the same bed next to her.

Just published August 18, 2026, the American Society for Transplantation and Cellular Therapy's newest guideline on hematopoietic cell transplantation for blastic plasmacytoid dendritic cell neoplasm.

The purpose of this guideline was to develop contemporary recommendations to guide the clinical practice of hematopoietic cell transplantation in patients with blastic plasmacytoid dendritic cell neoplasm or bpdcn the guideline also intended for these recommendations to foster a deeper understanding and greater awareness of the clinical complexity of bpdcn in today's rapid update we'll just be going over a summary of recommendations so for the full guideline make sure to check it out on guidelinecentral.com let's get started The panel recommends a bone marrow or BM aspirate biopsy, flow cytometry, a positron emission tomography slash computerized tomography or PET-CT, a diagnostic lumbar puncture or LP, and a thorough skin exam to confirm complete remission or CR prior to proceeding with a hematopoietic cell transplantation or HCT.

The panel recommends consolidation with an allogenic HCT in patients with confirmed first complete remission or CR1.

The panel suggests autologous HCT for patients in CR1 not considered fit for an allogenic HCT provided that there is no evidence of BM involvement with BPDCN.

So one of these three drugs would be considered standard for higher risk patients.

What about stem cell transplants? Are any patients getting a stem cell transplant?

yeah exactly so that's very very important to talk about and that is always mentioned in one way shape or form whether we recommend it or not for all of our patients when we see them and that's because a stem cell transplant is a potential cure for mds and it is the only potential cure for mds so it's important to consider.

As I said, MDS is a cancer of your bone marrow stem cells.

And so the idea with doing a stem cell transplant is trying to replace a patient's cancerous or abnormal stem cells with somebody else's, a donor's healthy stem cells.

And so it is something we have to consider.

Of course, a stem cell transplant has inherent risks.

Yeah.

afterwards,

Completing three rounds of intense chemotherapy, Olivia received a bone marrow transplant in June of 2024.

Sean, you were the donor.

At that time, how successful was the bone marrow transplant? And can you also talk, if you have any information on the alpha beta T cell depletion trial that was part of the transplant?

So the alpha beta T cell depletion is so there's a machine and they use magnetics and it takes the T cells out, which helps prevent like GVHD.

And I think Olivia was the 50th.

And I think she's one of the youngest and longest... child to be treated for t-a-t-m-a i think in the country

t-a-t-m-a can you um i don't know what that stands for is that something that i should have heard of because i never heard of it

Professor Kerry Brown on Zhu Rongji, who has died at the age of ninety-seven.

Now, Professor Paul Veys was a pediatric specialist who became director of the Bone Marrow Transplant Unit at Great Ormond Street Hospital in 1994.

He was recognized internationally for his pioneering treatment practices, which helped make procedures more safe and efficient for the children in his care.

I spoke to his friend, Dr. Robert Winn, consultant in bone marrow transplant at Royal Manchester Children's Hospital, to better understand the lasting impact Professor Veys had in the field.

Dr. Winn began by telling me about the first time that they met.

Which was the 1st of August 1989, when I was starting as a house officer in hematology at the London Hospital as he was leaving that day to take another job.

And so we have many coincidences together over the years.

How was he regarded in his profession?

Any OS data presented herein are exploratory and descriptive only and do not constitute a claim of OS benefit.

Hematopoietic stem cell transplant or HSCT remains our best shot at long-term cure in BPD-CM.

And the bridge to transplant story is one of the most critically significant findings from both the JCO 2022 paper and also the 2025 analysis in leukemia and lymphoma by Pemiraju and colleagues.

In total, 21 patients bridged to stem cell transplant directly after a TAG-induced response in the frontline setting, with 19 proceeding after achieving a CR or CRC and 2 achieving a PR.

14 received allogeneic HSCT and 7 autologous HSCT.

Patients typically went on to transplant after a median of four cycles of TAG therapy, and the median time from the last dose of TAG to transplant was 39 days, with a range from 23 days to 66 days.

Median overall survival was not reached in all transplanted patients at 36.6 months.

CLS occurred in only 10% of this group, which is lower than the overall first-line rate, likely reflecting the positive impact of early proactive monitoring.