Blood Advances Publishes GoBroad Study Supporting Allogeneic HSCT for Advanced ENKTCL

A study led by Dr. Zhihui Li from Beijing GoBroad Boren Hospital, GoBroad Healthcare Group, has been published in Blood Advances, one of the leading peer-reviewed journals in hematology. The study, titled "HSCT May Improve Survival in Advanced Extranodal NK/T-Cell Lymphoma: A Single-Center Retrospective Study," provides new evidence supporting the role of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with advanced extranodal natural killer/T-cell lymphoma (ENKTCL), while identifying biological markers that may facilitate precision risk stratification and individualized treatment.

ENKTCL is a rare and aggressive lymphoma closely associated with Epstein–Barr virus (EBV) infection. Although outcomes have improved substantially for patients with localized disease, the prognosis of those with advanced-stage or relapsed/refractory (R/R) ENKTCL remains poor. Allogeneic HSCT is currently considered the only potentially curative treatment for selected high-risk patients; however, optimal patient selection and transplant timing remain areas of active investigation.

In this retrospective single-center study, the investigators analyzed 34 patients with R/R ENKTCL who underwent allo-HSCT. Patients who achieved complete remission (CR) or partial remission (PR) before transplantation demonstrated significantly better survival outcomes, highlighting the importance of adequate disease control prior to transplantation while supporting timely referral rather than delaying transplant in pursuit of complete remission.

The study also evaluated multiple clinical and molecular factors associated with transplant outcomes. Prior treatment with PD-1 inhibitors, the number of previous treatment lines, and pre-transplant plasma EBV-DNA status were not independently associated with overall survival (OS) or progression-free survival (PFS). In contrast, a history of chronic active EBV infection (CAEBV), post-transplant EBV reactivation, and abnormalities in hemophagocytic lymphohistiocytosis (HLH)-associated genes, particularly LYST variants, were associated with inferior outcomes. Furthermore, TP53 mutations were identified as a risk factor for post-transplant relapse.

These findings suggest that integrating EBV-related clinical features, germline genetic susceptibility, and somatic genomic alterations could improve risk stratification for patients undergoing allo-HSCT. Such an approach may facilitate more individualized transplant decision-making, optimize post-transplant surveillance, and guide future maintenance strategies.

The study further supports a shift toward molecularly informed management of ENKTCL. By combining clinical characteristics with genomic and virological biomarkers, clinicians may be better equipped to identify patients most likely to benefit from transplantation and to develop personalized treatment strategies for this challenging disease.

The authors note that prospective multicenter studies will be needed to further validate these findings. Nevertheless, the study provides valuable evidence supporting the evolving role of allo-HSCT in high-risk ENKTCL and contributes to ongoing efforts to improve long-term outcomes through precision medicine.