Indication and benefit of upfront hematopoietic stem cell transplantation for T-cell lymphoblastic lymphoma in the era of ALL-type induction therapies View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2020-12-08

AUTHORS

Mari Morita-Fujita, Yasuyuki Arai, Satoshi Yoshioka, Takayuki Ishikawa, Junya Kanda, Tadakazu Kondo, Takashi Akasaka, Yasunori Ueda, Kazunori Imada, Toshinori Moriguchi, Kazuhiro Yago, Toshiyuki Kitano, Akihito Yonezawa, Masaharu Nohgawa, Akifumi Takaori-Kondo

ABSTRACT

Since the introduction of leukemia-type induction therapies for T-cell lymphoblastic lymphoma (T-LBL), improvements in the long-term outcomes of T-LBL have been reported. However, indications for and the appropriate timing of hematopoietic stem cell transplantation (HSCT) have not yet been established. Therefore, we performed a multicenter retrospective cohort study of patients with T-LBL treated using leukemia-type initial therapies to compare the outcomes after HSCT at different disease stages. We enrolled 21 patients with T-LBL from a total of 11 centers, and all patients received hyper-CVAD as a leukemia-type initial regimen. HSCT was performed during the CR1/PR1 (standard disease) stage in 11 patients, while it was completed at a later or non-remission (advanced disease) stage in 10 patients. Following HSCT, the overall survival rate was significantly greater in standard disease than in advanced-disease patients (79.5% vs. 30.0% at 5 years; hazard ratio (HR) 5.97; p = 0.03), with trend to the lower incidence of relapse in the former group (27.3% vs. 60.0% at 5 years; HR 2.29; p = 0.19). A prognostic difference was not detected between cases treated with allogeneic and autologous HSCTs. Our study suggests that frontline HSCT may be a feasible treatment option for T-LBL, even in the era of leukemia-type initial therapy. More... »

PAGES

21418

Journal

TITLE

Scientific Reports

ISSUE

1

VOLUME

10

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/s41598-020-78334-x

DOI

http://dx.doi.org/10.1038/s41598-020-78334-x

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1133315675

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/33293600


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32 schema:description Since the introduction of leukemia-type induction therapies for T-cell lymphoblastic lymphoma (T-LBL), improvements in the long-term outcomes of T-LBL have been reported. However, indications for and the appropriate timing of hematopoietic stem cell transplantation (HSCT) have not yet been established. Therefore, we performed a multicenter retrospective cohort study of patients with T-LBL treated using leukemia-type initial therapies to compare the outcomes after HSCT at different disease stages. We enrolled 21 patients with T-LBL from a total of 11 centers, and all patients received hyper-CVAD as a leukemia-type initial regimen. HSCT was performed during the CR1/PR1 (standard disease) stage in 11 patients, while it was completed at a later or non-remission (advanced disease) stage in 10 patients. Following HSCT, the overall survival rate was significantly greater in standard disease than in advanced-disease patients (79.5% vs. 30.0% at 5 years; hazard ratio (HR) 5.97; p = 0.03), with trend to the lower incidence of relapse in the former group (27.3% vs. 60.0% at 5 years; HR 2.29; p = 0.19). A prognostic difference was not detected between cases treated with allogeneic and autologous HSCTs. Our study suggests that frontline HSCT may be a feasible treatment option for T-LBL, even in the era of leukemia-type initial therapy.
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42 autologous hematopoietic stem cell transplantation
43 benefits
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54 former group
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