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

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

doi:10.1177/09636897221108890

Cell Transplantation (Jul 2022)

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

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

Affiliations

Jiahua Niu: Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
Zhixiao Chen: Department of Radiation Therapy, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Jie Gao: Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
Huiying Qiu: Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
Liping Wan: Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
Ying Wang: Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
Wenwei Wang: Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
Yin Tong: Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
Chongmei Huang: Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
Yu Cai: Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
Xiaowei Xu: Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
Kun Zhou: Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
Ying Zhang: Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
Xinxin Xia: Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
Chang Shen: Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
Yu Wei: Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
Tingfeng Chen: Department of Radiation Therapy, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Xianmin Song: Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
Jun Yang: Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China

DOI: https://doi.org/10.1177/09636897221108890
Journal volume & issue: Vol. 31

Abstract

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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.

Published in Cell Transplantation

ISSN: 0963-6897 (Print); 1555-3892 (Online)
Publisher: SAGE Publishing
Country of publisher: United States
LCC subjects: Medicine
Website: http://journals.sagepub.com/home/cll

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