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SOHO 2026 | Transplant decision-making: autoSCT vs alloSCT in T-cell lymphoma
Mary Jo Lechowicz, MD, Winship Cancer Institute, Emory University, Atlanta, GA, discusses the role of autologous and allogeneic stem cell transplantation (autoSCT and alloSCT) in T-cell lymphoma. Dr Lechowicz highlights ongoing uncertainty around the use of upfront autoSCT in patients with a complete response, while emphasizing that alloSCT remains preferred for certain high-risk subtypes. She also discusses the role of newer therapies in helping more patients with relapsed/refractory disease reach potentially curative transplantation. This interview took place at the 14th Annual Meeting of the Society of Hematologic Oncology (SOHO 2026) in Houston, TX.
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Transcript
So in terms of peripheral T-cell lymphoma or T-cell lymphomas in general, I think the first thing to say is that we still have questions about even doing the transplant upfront when we have complete responses, for autologous. And then for a couple of subtypes of T-cell lymphoma that have particularly bad outcomes or are historically not known to respond to chemotherapy, where autologous transplant wouldn’t be the best option for them...
So in terms of peripheral T-cell lymphoma or T-cell lymphomas in general, I think the first thing to say is that we still have questions about even doing the transplant upfront when we have complete responses, for autologous. And then for a couple of subtypes of T-cell lymphoma that have particularly bad outcomes or are historically not known to respond to chemotherapy, where autologous transplant wouldn’t be the best option for them. And so there are still some subtypes that we do an allogeneic transplant, like something called hepatosplenic T-cell lymphoma, as well as adult T-cell lymphoma/leukemia, if they have a donor. To get back to the question, though, I think in the relapsed/refractory setting, and this may be a slight oversimplification, but I think we’re right on the cusp of what these drugs can do or how we’re going to take them out for a ride, so to speak, in terms of treating the disease. And I think what in the short term is done is been able to be a bridge for more people to have a curative option of having a transplant in general versus having primary refractory disease. And at the same time, not only with the newer agents, but at the same time with some of the scientific and minimal residual disease and a number of those next-gen sequencing, we’re able to, we’re getting to a place where we can much better kind of fit some of these other treatments with a more specialized approach for every individual patient.
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