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Selection of hematopoietic stem cell transplantation for T-cell lymphoblastic lymphoma
BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is an important treatment for T-cell lymphoblastic lymphoma/leukemia (T-LBL). To compare the efficacy and influencing factors of autologous hematopoietic stem cell transplantation (auto-HSCT) with those of allogeneic hematopoietic stem cell...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10399448/ https://www.ncbi.nlm.nih.gov/pubmed/37546390 http://dx.doi.org/10.3389/fonc.2023.1193237 |
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author | Li, Zhen Zhang, Binglei Fan, Xinxin Gui, Ruirui Yu, Fengkuan Wang, Juan Zhang, Yanli Zhou, Keshu Liu, Yanyan Li, Yufu Ding, Jing Song, Yongping Zhou, Jian |
author_facet | Li, Zhen Zhang, Binglei Fan, Xinxin Gui, Ruirui Yu, Fengkuan Wang, Juan Zhang, Yanli Zhou, Keshu Liu, Yanyan Li, Yufu Ding, Jing Song, Yongping Zhou, Jian |
author_sort | Li, Zhen |
collection | PubMed |
description | BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is an important treatment for T-cell lymphoblastic lymphoma/leukemia (T-LBL). To compare the efficacy and influencing factors of autologous hematopoietic stem cell transplantation (auto-HSCT) with those of allogeneic hematopoietic stem cell transplantation (allo-HSCT) from different donors for the treatment of T-cell lymphoblastic lymphoma/leukemia (T-LBL) and provide a basis for selection of appropriate transplant methods and donors. METHODS: To provide evidence of appropriate transplant methods for these patients, we retrospectively summarized the clinical characteristics of 75 T-LBL patients receiving HSCT at Henan Cancer Hospital between March 2012 and October 2021. Overall survival (OS), progression-free survival (PFS), cumulative incidence of relapse (CIR), non-relapse mortality (NRM), and related factors affecting efficacy were analyzed. RESULTS: The 3-year CIR (39.9% vs 31.1%, P=0.745), 3-year PFS (60.1% vs 49.6%, P=0.434), and 3-year OS (62.8% vs 53.0%, P=0.450) were not significantly different between the auto-HSCT and allo-HSCT groups. However, the 3-year NRM was significantly higher in the allo-HSCT group (0% vs 27.2%, P=0.033). Multivariate analysis showed that the first complete remission (CR1) after HSCT was an independent influencing factor of higher OS (HR=2.498, P=0.029) and PFS (HR=2.576, P=0.016). The absence of mediastinal invasion in patients receiving HSCT was an independent influencing factor of better PFS (HR=2.977, P=0.029) and lower CIR (HR=4.040, P=0.027). With respect to the impact of donor source, the NRM in the unrelated donor (URD) and haploid donor (HPD) groups was significantly higher than that in the auto-HSCT group (P=0.021 and P=0.003, respectively), while there was no significant difference between matched sibling donors (MSD) and auto-HSCT. Compared with the MSD-HSCT group, the auto-HSCT group showed an increasing trend in 3-year CIR (39.9 ± 11.1% vs 32.6 ± 11.2%, P=0.697) and a lower trend in 3-year OS (62.8 ± 11.4% vs 64.4 ± 12.2%, P=0.929). CONCLUSIONS: HSCT is an effective consolidation treatment option for patients with T-LBL without mediastinal invasion and with CR1 before transplantation. For CR1 patients, auto-HSCT and MSD-HSCT are effective modalities for improving survival. In non-CR1 patients without an MSD, matched unrelated donors and haploidentical donor transplantations are the best treatment options to reduce relapse and improve prognosis. |
format | Online Article Text |
id | pubmed-10399448 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-103994482023-08-04 Selection of hematopoietic stem cell transplantation for T-cell lymphoblastic lymphoma Li, Zhen Zhang, Binglei Fan, Xinxin Gui, Ruirui Yu, Fengkuan Wang, Juan Zhang, Yanli Zhou, Keshu Liu, Yanyan Li, Yufu Ding, Jing Song, Yongping Zhou, Jian Front Oncol Oncology BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is an important treatment for T-cell lymphoblastic lymphoma/leukemia (T-LBL). To compare the efficacy and influencing factors of autologous hematopoietic stem cell transplantation (auto-HSCT) with those of allogeneic hematopoietic stem cell transplantation (allo-HSCT) from different donors for the treatment of T-cell lymphoblastic lymphoma/leukemia (T-LBL) and provide a basis for selection of appropriate transplant methods and donors. METHODS: To provide evidence of appropriate transplant methods for these patients, we retrospectively summarized the clinical characteristics of 75 T-LBL patients receiving HSCT at Henan Cancer Hospital between March 2012 and October 2021. Overall survival (OS), progression-free survival (PFS), cumulative incidence of relapse (CIR), non-relapse mortality (NRM), and related factors affecting efficacy were analyzed. RESULTS: The 3-year CIR (39.9% vs 31.1%, P=0.745), 3-year PFS (60.1% vs 49.6%, P=0.434), and 3-year OS (62.8% vs 53.0%, P=0.450) were not significantly different between the auto-HSCT and allo-HSCT groups. However, the 3-year NRM was significantly higher in the allo-HSCT group (0% vs 27.2%, P=0.033). Multivariate analysis showed that the first complete remission (CR1) after HSCT was an independent influencing factor of higher OS (HR=2.498, P=0.029) and PFS (HR=2.576, P=0.016). The absence of mediastinal invasion in patients receiving HSCT was an independent influencing factor of better PFS (HR=2.977, P=0.029) and lower CIR (HR=4.040, P=0.027). With respect to the impact of donor source, the NRM in the unrelated donor (URD) and haploid donor (HPD) groups was significantly higher than that in the auto-HSCT group (P=0.021 and P=0.003, respectively), while there was no significant difference between matched sibling donors (MSD) and auto-HSCT. Compared with the MSD-HSCT group, the auto-HSCT group showed an increasing trend in 3-year CIR (39.9 ± 11.1% vs 32.6 ± 11.2%, P=0.697) and a lower trend in 3-year OS (62.8 ± 11.4% vs 64.4 ± 12.2%, P=0.929). CONCLUSIONS: HSCT is an effective consolidation treatment option for patients with T-LBL without mediastinal invasion and with CR1 before transplantation. For CR1 patients, auto-HSCT and MSD-HSCT are effective modalities for improving survival. In non-CR1 patients without an MSD, matched unrelated donors and haploidentical donor transplantations are the best treatment options to reduce relapse and improve prognosis. Frontiers Media S.A. 2023-07-20 /pmc/articles/PMC10399448/ /pubmed/37546390 http://dx.doi.org/10.3389/fonc.2023.1193237 Text en Copyright © 2023 Li, Zhang, Fan, Gui, Yu, Wang, Zhang, Zhou, Liu, Li, Ding, Song and Zhou https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Oncology Li, Zhen Zhang, Binglei Fan, Xinxin Gui, Ruirui Yu, Fengkuan Wang, Juan Zhang, Yanli Zhou, Keshu Liu, Yanyan Li, Yufu Ding, Jing Song, Yongping Zhou, Jian Selection of hematopoietic stem cell transplantation for T-cell lymphoblastic lymphoma |
title | Selection of hematopoietic stem cell transplantation for T-cell lymphoblastic lymphoma |
title_full | Selection of hematopoietic stem cell transplantation for T-cell lymphoblastic lymphoma |
title_fullStr | Selection of hematopoietic stem cell transplantation for T-cell lymphoblastic lymphoma |
title_full_unstemmed | Selection of hematopoietic stem cell transplantation for T-cell lymphoblastic lymphoma |
title_short | Selection of hematopoietic stem cell transplantation for T-cell lymphoblastic lymphoma |
title_sort | selection of hematopoietic stem cell transplantation for t-cell lymphoblastic lymphoma |
topic | Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10399448/ https://www.ncbi.nlm.nih.gov/pubmed/37546390 http://dx.doi.org/10.3389/fonc.2023.1193237 |
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