TY - JOUR

T1 - Impact of conditioning with TBI in adult patients with T-cell ALL who receive a myeloablative allogeneic stem cell transplantation

T2 - a report from the acute leukemia working party of EBMT

AU - Cahu, X

AU - Labopin, M

AU - Giebel, S

AU - Aljurf, M

AU - Kyrcz-Krzemien, S

AU - Socié, G

AU - Eder, M

AU - Bonifazi, F

AU - Bunjes, D

AU - Vigouroux, S

AU - Michallet, M

AU - Stelljes, M

AU - Zuckerman, T

AU - Finke, J

AU - Passweg, J

AU - Yakoub-Agha, I

AU - Niederwieser, D

AU - Sucak, G

AU - Sengeløv, Henrik

AU - Polge, E

AU - Nagler, A

AU - Esteve, J

AU - Mohty, M

AU - Acute Leukemia Working Party of EBMT

PY - 2016

Y1 - 2016

N2 - Allogeneic hematopoietic stem cell transplantation (allo-SCT) is a therapeutic option for adult patients with T-cell ALL (T-ALL). Meanwhile, few allo-SCT data specific to adult T-ALL have been described thus far. Specifically, the optimal myeloablative conditioning regimen is unknown. In this retrospective study, 601 patients were included. Patients received allo-SCT in CR1, CR2, CR >2 or in advanced disease in 69%, 15%, 2% and 14% of cases, respectively. With an overall follow-up of 58 months, 523 patients received a TBI-based regimen, whereas 78 patients received a chemotherapy-based regimen including IV busulfan-cyclophosphamide (IV Bu-Cy) (n=46). Unlike patients aged ⩾35 years, patients aged <35 years who received a TBI-based regimen displayed an improved outcome compared with patients who received a chemotherapy-based regimen (5-year leukemia-free survival (LFS) of 50% for TBI versus 18% for chemo-only regimen or IV Bu-Cy regimens, P=10(-5) and 10(-4), respectively). In multivariate analysis, use of TBI was associated with an improved LFS (hazard ratio (HR)=0.55 (0.34-0.86), P=0.01) and overall survival (HR=0.54 (0.34-0.87), P=0.01) in patients aged <35 years. In conclusion, younger adult patients with T-ALL entitled to receive a myeloablative allo-SCT may benefit from TBI-based regimens.

AB - Allogeneic hematopoietic stem cell transplantation (allo-SCT) is a therapeutic option for adult patients with T-cell ALL (T-ALL). Meanwhile, few allo-SCT data specific to adult T-ALL have been described thus far. Specifically, the optimal myeloablative conditioning regimen is unknown. In this retrospective study, 601 patients were included. Patients received allo-SCT in CR1, CR2, CR >2 or in advanced disease in 69%, 15%, 2% and 14% of cases, respectively. With an overall follow-up of 58 months, 523 patients received a TBI-based regimen, whereas 78 patients received a chemotherapy-based regimen including IV busulfan-cyclophosphamide (IV Bu-Cy) (n=46). Unlike patients aged ⩾35 years, patients aged <35 years who received a TBI-based regimen displayed an improved outcome compared with patients who received a chemotherapy-based regimen (5-year leukemia-free survival (LFS) of 50% for TBI versus 18% for chemo-only regimen or IV Bu-Cy regimens, P=10(-5) and 10(-4), respectively). In multivariate analysis, use of TBI was associated with an improved LFS (hazard ratio (HR)=0.55 (0.34-0.86), P=0.01) and overall survival (HR=0.54 (0.34-0.87), P=0.01) in patients aged <35 years. In conclusion, younger adult patients with T-ALL entitled to receive a myeloablative allo-SCT may benefit from TBI-based regimens.

KW - Adult

KW - Busulfan

KW - Cyclophosphamide

KW - Disease-Free Survival

KW - Female

KW - Follow-Up Studies

KW - Hematopoietic Stem Cell Transplantation

KW - Humans

KW - Male

KW - Precursor T-Cell Lymphoblastic Leukemia-Lymphoma

KW - Registries

KW - Survival Rate

KW - Transplantation Conditioning

KW - Whole-Body Irradiation

KW - Comparative Study

KW - Journal Article

U2 - 10.1038/bmt.2015.278

DO - 10.1038/bmt.2015.278

M3 - Journal article

C2 - 26618548

VL - 51

SP - 351

EP - 357

JO - Bone

JF - Bone

SN - 8756-3282

ER -