Efficacy and prognostic factors of allogeneic hematopoietic stem cell transplantation treatment for adolescent and adult Tlymphoblastic leukemia /lymphoma : a large cohort multicenter study in China

© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature..

T lymphoblastic leukemia /lymphoma (T-ALL/LBL) is a rare and highly aggressive neoplasm of lymphoblasts. We evaluated 195 T-ALL/LBL adolescent and adult patients who received ALL-type chemotherapy alone (chemo,n = 72) or in combination with autologous hematopoietic stem cell transplantation(auto-HSCT,n = 23) or allogeneic hematopoietic stem cell transplantation(allo-HSCT,n = 100) from January 2006 to September 2020 in three Chinese medical centers. 167 (85.6%) patients achieved overall response (ORR) with 138 complete response (CR) patients (70.8%) and 29 partial response (PR) patients (14.8%). Until October 1, 2023, no difference was found in 5-year overall survival (5-OS) and 5-year progression free survival(5-PFS) between allo-HSCT and auto-HSCT (5-OS 57.9% vs. 36.7%, P = 0.139, 5-year PFS 49.4% vs. 28.6%, P = 0.078) for patients who achieved CR, for patients who achieved PR, allo-HSCT recipients had higher 5-OS compared with chemo alone recipients (5-OS 23.8% vs. 0, P = 0.042). For patients undergoing allo-HSCT, minimal residual disease (MRD) negative population showed better 5-OS survival compared with MRD positive patients (67.8% vs. 19.6%, p = 0.000). There were no significant differences between early T-cell precursor (ETP), NON-ETP patients with or without expression of one or more myeloid-associated or stem cell-associated (M/S+) markers (NON-ETP with M/S+, NON-ETP without M/S+) groups in allo-HSCT population for 5-OS. (62.9% vs. 54.5% vs.48.4%, P > 0.05). Notch mutations were more common in patients with non-relapsed/refractory disease than relapsed/refractory disease (χ² =4.293, P = 0.038). In conclusion, Allo-HSCT could be an effective consolidation therapy not just for patients with CR, but also for those who achieved PR. The prognosis is significantly improved by obtaining MRD negative prior to allogeneic transplantation.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - year:2024

Enthalten in:

Annals of hematology - (2024) vom: 06. Apr.

Sprache:

Englisch

Beteiligte Personen:

Luo, Lan [VerfasserIn]
Jiao, Yang [VerfasserIn]
Li, Yan [VerfasserIn]
Yang, Ping [VerfasserIn]
Gao, Jinjie [VerfasserIn]
Huang, Sai [VerfasserIn]
Huang, Wenyang [VerfasserIn]
Wang, Jijun [VerfasserIn]
Dong, Fei [VerfasserIn]
Ke, Xiaoyan [VerfasserIn]
Zou, Dehui [VerfasserIn]
Gao, Chunji [VerfasserIn]
Jing, Hongmei [VerfasserIn]

Links:

Volltext

Themen:

Allogeneic hematopoietic stem cell transplantation (allo-HSCT)
Autologous hematopoietic stem cell transplantation (auto-HSCT)
Early T-cell precursor (ETP)
Journal Article
Minimal residual disease (MRD)
T lymphoblastic leukemia /lymphoma (T-ALL/LBL)

Anmerkungen:

Date Revised 06.04.2024

published: Print-Electronic

Citation Status Publisher

doi:

10.1007/s00277-024-05719-7

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM370709489