Optimal timing and impact of allogeneic peripheral blood stem cell transplantation in adult T-cell lymphoblastic lymphoma: insights from a large cohort multi-center real-world study in Shanghai

Fangfang Yu; Jiahua Niu; Jianmin Yang; Jian Hou; Siguo Hao; Aibin Liang; Hong Xiong; Qi Zhu; Ligen Liu; Jun Shi; Juan Du; Bobin Chen; Rong Wei; Wenli Zhao; Lihua Sun; Yunhua Hou; Rong Tao; Xianmin Song

doi:10.1038/s41409-024-02500-2

Optimal timing and impact of allogeneic peripheral blood stem cell transplantation in adult T-cell lymphoblastic lymphoma: insights from a large cohort multi-center real-world study in Shanghai

Bone Marrow Transplant. 2024 Dec 20. doi: 10.1038/s41409-024-02500-2. Online ahead of print.

Authors

Fangfang Yu^#¹, Jiahua Niu^#¹, Jianmin Yang², Jian Hou³, Siguo Hao⁴, Aibin Liang⁵, Hong Xiong⁶, Qi Zhu⁷, Ligen Liu⁸, Jun Shi⁹, Juan Du¹⁰, Bobin Chen¹¹, Rong Wei¹², Wenli Zhao¹³, Lihua Sun¹⁴, Yunhua Hou¹⁵, Rong Tao¹⁶, Xianmin Song¹⁷

Affiliations

¹ Department of Hematology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200080, China.
² Department of Hematology, Institute of Hematology, Changhai Hospital, Naval Medical University, Shanghai, 200433, China.
³ Department of Hematology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200127, China.
⁴ Department of Hematology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200092, China.
⁵ Department of Hematology, Tongji Hospital of Tongji University, Shanghai, 200065, China.
⁶ Department of Hematology, Xuhui Hospital, Fudan University, Shanghai, 200031, China.
⁷ Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
⁸ Department of Hematology, Shanghai Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China.
⁹ Department of Hematology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
¹⁰ Department of Hematology, Myeloma & Lymphoma Center, Shanghai Changzheng Hospital, 200003, Shanghai, China.
¹¹ Department of Hematology, Huashan Hospital, Fudan University, Shanghai, China.
¹² Department of Hematology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China.
¹³ Department of Hematology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital South Campus, Shanghai Fengxian District Central Hospital, Shanghai, 201499, China.
¹⁴ Department of Hematology, Zhongshan Hospital Qingpu Branch, Fudan University, Shanghai, 201700, China.
¹⁵ Department of Hematology and Oncology, Minhang Hospital, Fudan University, Shanghai, 201199, China.
¹⁶ Department of Lymphoma, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. [email protected].
¹⁷ Department of Hematology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200080, China. [email protected].

^# Contributed equally.

PMID: 39706878
DOI: 10.1038/s41409-024-02500-2

Abstract

In this real-world study, 153 adult T-cell lymphoblastic lymphoma (T-LBL) patients from sixteen centers in Shanghai were enrolled. Out of them, 103 (67.3%) achieved complete remission (CR). The 2-year overall survival (OS) and progression-free survival (PFS) were 56.3% and 47.6%, respectively. In multivariate analysis, CR after induction treatment significantly improved the OS (p = 0.002) and PFS (p = 0.001). Among CR patients, allogeneic peripheral blood stem cell transplantation (allo-PBSCT) significantly lowered the cumulative incidence of relapse (CIR) compared to autologous PBSCT (p = 0.043) and non-SCT (p = 0.001). Among patients undergoing allo-PBSCT in CR, early (within four induction courses) and late CR (after four induction courses) didn't impact the prognosis with similar 2-year OS (p = 0.590), PFS (p = 0.858), CIR (p = 0.50), and non-relapse mortality (NRM) (p = 0.110). Early and deferred allo-PBSCT for early CR patients also yielded similar 2-year OS (p = 0.640), PFS (p = 0.970), CIR (p = 0.994), and NRM (p = 0.974). As a time-dependent covariate, allo-PBSCT presented a positive effect on PFS (p = 0.018) and had a trend toward better OS (p = 0.064). These data suggested that allo-PBSCT should be considered for T-LBL patients upon achieving CR to enhance survival and reduce relapse risk.

Grants and funding

81570148/National Natural Science Foundation of China (National Science Foundation of China)