Tandem autologous hematopoietic stem cell transplantation for treatment of adult T-cell lymphoblastic lymphoma: a multiple center prospective study in China
Yao Liu,
Jun Rao,
Jiali Li,
Qin Wen,
Sanbin Wang,
Shifeng Lou,
Tonghua Yang,
Bin Li,
Lei Gao,
Cheng Zhang,
Peiyan Kong,
Li Gao,
Maihong Wang,
Lidan Zhu,
Xixi Xiang,
Sha Zhou,
Xue Liu,
Xiangui Peng,
Jiangfan Zhong,
Xi Zhang
Affiliations
Yao Liu
Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing, China;
Jun Rao
Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing
Jiali Li
Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing, China;
Qin Wen
Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing, China;
Sanbin Wang
Dept. Hematology, General Hospital of Kunming Military Region of People Liberation Army, Kunming;
Shifeng Lou
Department of Hematology, Second Affiliated Hospital of Chongqing Medical University,Chongqing,China;
Tonghua Yang
Department of Hematology, Yunan Provincial People Hospital, Kunming, China;
Bin Li
Department of Hematology, Second Yunnan Provincial People Hospital, Yunnan, China;
Lei Gao
Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing, China;
Cheng Zhang
Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing, China;
Peiyan Kong
Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing
Li Gao
Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing, China;
Maihong Wang
Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing, China;
Lidan Zhu
Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing, China;
Xixi Xiang
Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing, China;
Sha Zhou
Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing, China;
Xue Liu
Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing, China;
Xiangui Peng
Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing, China;
Jiangfan Zhong
Department of Pathology, University of Southern California, Keck School of Medicine
Xi Zhang
Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing, China;
T-cell lymphoblastic lymphoma (T-LBL) is a highly aggressive form of lymphoma with poor clinical outcomes and lacks of a standard treatment regimen. In this study, we assessed the safety and efficacy of tandem autologous hematopoietic stem cell transplantation (auto-HSCT) strategy for adult T-LBL and evaluated prognostic factors affecting survival. 181 Newly-diagnosed adult T-LBL patients were enrolled, 89 patients were treated with chemotherapy alone, 46 patients were allocated to single auto-HSCT group, 46 patients were treated with tandem auto-HSCT. The median follow-up time was 37 months, the 3-year progression/relapse rate of the tandem auto-HSCT group was significantly lower than that of the single auto-HSCT group and chemotherapy group (26.5% vs 53.1% and 54.8%). The 3-year PFS and OS rate of the tandem auto-HSCT group (73.5% and 76.3%) were significantly higher than those of the single auto-HSCT group (46.9% and 58.3%) and the chemotherapy group (45.1% and 57.1%). In the tandem auto-HSCT group, age and disease status after the first transplantation impacted the OS and PFS. Multivariate analysis identified that disease status after the first transplantation was the only independent prognostic factor for patients treated with tandem-HSCT. In addition, diagnostic models of the initial CD8+CD28+/CD8+CD28- T cell ratio in predicting the disease status were found to be significant. Taken together, tandem auto-HSCT can be considered an optimal strategy for adult T-LBL patients (ChiCTR-ONN-16008480).
