Total Body Irradiation-Based Conditioning Regimen Improved the Survival of Adult Patients With T-Cell Lymphoblastic Lymphoma After Allogeneic Peripheral Blood Stem Cell Transplantation.

Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is one of the consolidation modalities for adult patients with T-cell lymphoblastic lymphoma (T-LBL). However, the optimal conditioning regimen needs to be explored. In the present study, 40 patients with T-LBL undergoing allo-HSCT were retrospectively analyzed, including 23/40 (57.5%) with total body irradiation (TBI)-based conditioning regimen and 17/40 (42.5%) with busulfan (BU)-based regimen. TBI-based regimen significantly increased the cumulative incidence (CI) of grade II to IV acute graft-versus-host disease (aGvHD) as compared with BU-based regimen (13.0% vs 0%, P = 0.000). The relapse risk was significantly lowered in TBI-based group with a 2-year CI of relapse (CIR) of 9.1% as compared with that of 49.6% in BU-based group (P = 0.008). The 1-year and 2-year non-relapse mortalities (NRMs) for all patients were 5.0% and 10.3%, respectively. The 1-year and 2-year NRMs were 8.9% and 16.0% in TBI-based group, and 0.00% and 0.00% in BU-based group (P = 0.140). The 2-year probabilities of overall survival (OS) and relapse-free survival (RFS) were 83.0% [95% confidence interval, 63.4%-100%] and 74.0% (95% confidence interval, 54.4%-93.6%) in TBI-based group, which were higher than that of 35.0% (95% confidence interval, 0.0%-72.2%) and 50.0% (95% confidence interval, 24.5%-75.4%) in BU-based group, respectively (P = 0.020 for OS and P = 0.081 for RFS). In multivariate analysis, TBI-based regimen significantly reduced the risk of relapse [subdistribution hazard ratio (SHR) = 0.030, 95% CI, 0.002-0.040, P = 0.000] and improved the OS [hazard ratio (HR) 0.121, 95% CI, 0.021-0.683, P = 0.017] as an independent prognostic factor. These results suggested that TBI-based regimen might be an optimal choice for adult patients with T-LBL undergoing allo-HSCT.

• Authors: Jiahua Niu, Zhixiao Chen, Jie Gao, Huiying Qiu, Liping Wan, Ying Wang, Wenwei Wang, Yin Tong, Chongmei Huang, Yu Cai, Xiaowei Xu, Kun Zhou, Ying Zhang, Xinxin Xia, Chang Shen, Yu Wei, Tingfeng Chen, Xianmin Song, Jun Yang
• Journal: Cell transplantation (Cell Transplant) 2022 Jan-Dec Vol. 31 Pg. 9636897221108890 ISSN: 1555-3892 [Electronic] United States
• PMID: 35801674 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Busulfan

Topics

• Adult
• Busulfan (therapeutic use)
• Graft vs Host Disease (etiology)
• Hematopoietic Stem Cell Transplantation (methods)
• Humans
• Peripheral Blood Stem Cell Transplantation (adverse effects)
• Precursor Cell Lymphoblastic Leukemia-Lymphoma (complications, therapy)
• Recurrence
• Retrospective Studies
• T-Lymphocytes
• Transplantation Conditioning (methods)
• Whole-Body Irradiation (adverse effects)