Allogeneic HSCT Plus Myeloablative Conditioning a ‘Valid Option’ for BPDCN

Allogeneic hematopoietic stem cell transplant (HSCT) plus myeloablative conditioning led to an overall survival (OS) rate of nearly 75% in patients with blastic plasmacytoid dendritic cell neoplasm (BPDCN), according to a recent study.

Yue Lu, MD, of the Hebei Yanda Lu Daopei Hospital, and colleagues conducted the study and published its results in Leukemia and Lymphoma.

The study was conducted because BPDCN “is a rare hematopoietic malignancy characterized by poor prognosis even following an [allogeneic HSCT],” Dr. Lu and colleagues wrote.

Researchers retrospectively analyzed 15 patients diagnosed with BPDCN who received allogeneic HSCT and myeloablative conditioning at a single center. Most patients were male (73.3%), and the median patient age was 36 years (range, 6-70 years).

All patients initially presented with extramedullary lesions, 13 patients had cutaneous lesions, one patient had breast lesions, and one patient had lesions in their lymph nodes. All patients had bone marrow involvement, and two were diagnosed with central nervous system leukemia. Prior to transplant, nine patients were in their first complete remission (CR), and six patients were in their second CR. All patients received a myeloablative conditioning regimen and an unmanipulated graft.

At a median follow-up of 34 months, the overall leukemia-free survival and OS rates were 73.3%. All patients had successful engraftment with full donor chimerism, but researchers reported poor graft function in one patient. Acute graft-versus-host disease (GVHD) was reported in three patients (20%), and chronic GVHD was reported in seven patients (46.6%). Chronic GVHD was mild in six of the seven patients.

Allogeneic HSCT plus myeloablative conditioning is a “valid option for BPDCN patients in CR,” Dr. Lu and colleagues concluded.

Lu Y, Sun RJ, Zhang JP, et al. Allogeneic hematopoietic stem cell transplantation with myeloablative conditioning regimen for blastic plasmacytoid dendritic cell neoplasm patients in complete remission: a single center study. Leuk Lymphoma. 2022. doi:10.1080/10428194.2022.2118531