4.6 Article

Survival and prognostic analysis of T-cell lymphoblastic lymphoma patients treated with dose-adjusted BFM-90 regimen

Journal

AGING-US
Volume 14, Issue 7, Pages 3203-3215

Publisher

IMPACT JOURNALS LLC

Keywords

T-cell lymphoblastic lymphoma; BFM-90; conditional survival; neutrophil-to-lymphocyte ratio

Funding

  1. National Nature Science Foundation of China [82070205, 81870154, 81972807, 81670187, 81970179, 81700197]
  2. Beijing Natural Science Foundation [7202025, 7202026]
  3. Capital's Funds for Health Improvement and Research [2018-1-2151]
  4. Beijing Municipal Science and Technology Commission [Z181100001918019]
  5. Beijing Municipal Administration of Hospitals' Ascent Plan [DFL20151001]

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This study investigated the long-term prognosis and prognostic factors of T-cell lymphoblastic lymphoma patients treated with first-line dose-adjusted BFM-90 regimen. It was found that survival probability improved significantly with every additional year survived, and patients who underwent APBSCT transplantation had better survival rates. Baseline NLR >= 4.95 was identified as an independent risk factor for patients.
We aimed to investigate the long-term prognosis and prognostic factors of T-cell lymphoblastic lymphoma (T-LBL) patients who received dose-adjusted Berlin-Frankfurt-Munster (BFM)-90 regimen as first-line therapy in our center. A total of 145 T-LBL patients who underwent first-line dose-adjusted BFM-90 was retrospectively reviewed. Conditional survival analysis was used to evaluate the long-term prognosis of patients. Receiver operating characteristic (ROC) curve was applied to determine the optimal cut-off value for neutrophil-to-lymphocyte ratio (NLR). Estimated 3-year overall survival (OS) and progression-free survival (PFS) rates for overall were 66.8% and 58.4%, respectively. Conditional survival analysis showed that for patients having survived 3 and 5 years or more after the completion of the treatment, the estimated subsequent 3-year OS thereafter increased to 85.7% and 94.3, respectively. Patients receiving consolidation APBSCT (Autologous peripheral blood stem cell transplantation) after BFM-90 regimen had superior 3-year OS than those with non-APBSCT (79.1% vs. 33.4%, p<0.001). We also discovered that baseline NLR >= 4.95 was negatively associated with OS (HR=2.75, 95% CI 1.55-4.89, p=0.015) and PFS (HR=2.07, 95% CI 1.25-4.96, p=0.021) via multivariable analysis. Conclusions: The survival probability of T-LBL patients treated with first-line dose-adjusted BFM-90 has improved significantly as patients have survived for every additional year. The addition of consolidation APBSCT following dose-adjusted BFM-90 therapy bring further survival benefits for those patients. Baseline NLR >= 4.95 was an independent risk factor for T-LBL patients in our study.

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