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 - 2016/3/1
Y1 - 2016/3/1
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
SN - 8756-3282
VL - 51
SP - 351
EP - 357
JO - Bone
JF - Bone
ER -