Outcome of Allogeneic Stem Cell Transplantation in T Cell Lymphoblastic Lymphoma

Background T cell lymphoblastic lymphoma (T-LBL) is an aggressive form of non-Hodgkin lymphoma occurring in predominantly adolescent and young adults.Although T-LBL is achemotherapy-sensitive disease, relapse is common with conventional chemotherapies. Allogeneic stem cell transplantation (allo-SCT) may be effective in patients with high-risk features or relapsed/refractory patients.

Objective To investigate the effect of allo-SCT in the treatment of T-LBL.

Methods T-LBL patients who received allo-SCT from August 2007 to March 2017 in our center were recruited in this retrospective study.

Results (1) 37 T-LBL patients were enrolled in this study, including 25 males and 12 females with a median age of 21 years old (ranged from 8 to 47 years old). A total of 10 (27%) from HLA-matched siblings,24 (65%) patients received grafts from haploidentical family donors, 2 (5%) from matched unrelated donors,and 1(3%) from cord blood. (2) With a median follow up of 20 months (4 - 119 months), 3 year overall survival (OS) ,progression-free survival (PFS) and relapse were 71.7%, 69.5% and 23.6%,respectively. (3) 12/37 patients developed acute graft-versus-host diease (GVHD) ,including 6 (16%) with grade III-IV aGVHD. 8/37 patients developed chronic GVHD. The transplant-related mortality was 13.5%.(4) Allo-SCT in first complete remission (CR1) was associated with improved OS (3-year estimates: 79.1% vs 45.5%, P=0.001) and improved PFS (62.5% vs 39.1%, P=0.001). On multivariable analysis, allo-SCT in CR1 was the factor associated with the prolonged OS (hazard ratio [HR] = 0.095;95% confidence interval [CI] : 0.014-0.655; P=0.017) and PFS (HR=,0.085 95% CI=0.014-0.515; P=0.007).

Conclusion Allo-SCT for T-LBL patients revealed a proming outcome. Disease status the only independent factor affecting the OS and PFS, and allo-SCT should be recommended in CR1.