Reader Responses: Is upfront transplant appropriate for this patient with a rare cutaneous T-cell lymphoma?

Here’s how readers responded to a You Make the Call question about the role of transplant in gamma-delta T-cell lymphoma.

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Yes, once the patient has achieved PET-negative complete remission, perform consolidation therapy with autologous hematopoietic cell transplantation (AHCT).

Farnoush Abar, MD, MPH
Corvallis, OR

Due to the fact that gamma-delta T-cell lymphomas have a very poor prognosis, I would advise an allogeneic hematopoietic cell transplantation (alloHCT) if there is at least a partial response to CHOEP and a suitable donor can be found. Otherwise, I would recommend an AHCT as consolidation treatment after CHOEP.

Stamatis Karakatsanis, MD
Athens, Greece

Yes. In a young patient with gamma-delta T-cell lymphoma, the only curative approach is alloHCT.

Guillermo Sanz, MD, PhD
Hospital Universitario y 
Politécnico de La Fe
Valencia, Spain

I would see what the response is to chemotherapy and decide about a transplant later.

Behrooz Zidehsarai, MD
Redding, CA

I would treat with oral methotrexate and assess the response. If the response is suboptimal, I would consider six cycles of CHOEP with or without methotrexate maintenance. I would consider an autograft if the lymphoma relapses and brentuximab vedotin as a part of a salvage regimen.

Mobin Paul, MD, MBBS
Rajagiri Hospital
Kerala, India

No. Consider transplant after initial treatment with targeted therapy.

Aubrey A. Lurie, MD
VA Medical Center
Shreveport, LA

Yes.

David H. Ross, MD
Cherry Hill, NJ