Table 5.

Patients with T-cell ALL to be considered for alloHCT in first remission

Indication*Reference
1 Failure to achieve CR after induction 60 
2 MRD >1 × 10−4 after 2 courses of therapy 30, 60 
3 Presenting WCC >100 × 109/L† 4 
4 Complex cytogenetics ≥5 abnormalities 4, 30 
5 Early T-cell precursor ALL† 9, 10, 17 
6 Unfavorable N/F/PTEN/RAS genetics 29 
7 Age 40-65 y, especially if delays occur in treatment due to toxicity 64 
Indication*Reference
1 Failure to achieve CR after induction 60 
2 MRD >1 × 10−4 after 2 courses of therapy 30, 60 
3 Presenting WCC >100 × 109/L† 4 
4 Complex cytogenetics ≥5 abnormalities 4, 30 
5 Early T-cell precursor ALL† 9, 10, 17 
6 Unfavorable N/F/PTEN/RAS genetics 29 
7 Age 40-65 y, especially if delays occur in treatment due to toxicity 64 

TRM, treatment-related mortality.

*

Donor quality and the Hematopoietic Cell Transplantation Comorbidity index also affect the decision.65  alloHCT may reduce relapse risk but this should be balanced against the predicted TRM.

†

MRD negativity may override these unfavorable prognostic factors.

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