期刊
TRANSPLANTATION AND CELLULAR THERAPY
卷 28, 期 4, 页码 -出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jtct.2022.01.017
关键词
Prolymphocytic leukemia; T-PLL; Allogeneic stem cell transplant
资金
- National Cancer Institute [U24CA076518]
- National Heart, Lung and Blood Institute
- National Institute of Allergy and Infectious Diseases
- Health Resources and Services Administration [HHSH250201700006C]
- Office of Naval Research [N00014-20-1-2705, N00014-20-1-2832]
- Be the Match Foundation
- Medical College of Wisconsin
- National Marrow Donor Program
- AbbVie
- Accenture
- Actinium Pharmaceuticals
- Adaptive Biotechnologies
- Adienne SA
- Allovir
- Amgen
- Astellas Pharma US
- bluebird bio
- Bristol Myers Squibb
- CareDx
- CSL Behring
- CytoSen Therapeutics
- Daiichi Sankyo
- Eurofins Viracor
- ExcellThera
- Fate Therapeutics
- GamidaCell
- Genentech
- Gilead
- GlaxoSmithKline
- Incyte
- Janssen/Johnson Johnson
- Jasper Therapeutics
- Jazz Pharmaceuticals
- Karyopharm Therapeutics
- Kiadis Pharma
- Kite Pharma
- Kyowa Kirin
- Legend
- Magenta Therapeutics
- Medac
- Medexus
- Merck Co
- Millennium
- Miltenyi Biotec
- MorphoSys
- Novartis Pharmaceuticals
- Omeros
- Oncopeptides
- Orca Biosystems
- Ossium Health
- Pfizer
- Pharmacyclics
- Priothera
- Sanofi Genzyme
- Seagen
- Stemcyte
- Takeda Pharmaceuticals
- Tscan
- Vertex
- Vor Biopharma
- Xenikos BV
This study analyzed the outcomes of alloHCT in 266 patients with T-PLL and aimed to identify predictors of post-transplantation relapse and survival. The results showed that reduced-intensity conditioning alloHCT was associated with long-term disease-free survival.
T cell prolymphocytic leukemia (T-PLL) is a rare, aggressive malignancy with limited treatment options and poor long-term survival. Previous studies of allogeneic hematopoietic cell transplantation (alloHCT) for T-PLL are limited by small numbers, and descriptions of patient and transplantation characteristics and outcomes after alloHCT are sparse. In this study, we evaluated outcomes of alloHCT in patients with T-PLL and attempted to identify predictors of post-transplantation relapse and survival. We conducted an analysis of data using the Center for International Blood and Marrow Transplant Research database on 266 patients with T-PLL who underwent alloHCT between 2008 and 2018. The 4-year rates of overall survival (OS), disease-free survival (DFS), relapse, and treatment-related mortality (TRM) were 30.0% (95% confidence interval [CI], 23.8% to 36.5%), 25.7% (95% CI, 20% to 32%), 41.9% (95% CI, 35.5% to 48.4%), and 32.4% (95% CI, 26.4% to 38.6%), respectively. In multivariable analyses, 3 variables were associated with inferior OS: receipt of a myeloablative conditioning (MAC) regimen (hazard ratio [HR], 2.18; P <.0001), age >60 years (HR, 1.61; P =.0053), and suboptimal performance status, defined by Karnofsky Performance Status (KPS) <90 (HR, 1.53; P =.0073). Receipt of an MAC regimen also was associated with increased TRM (HR, 3.31; P <.0001), an elevated cumulative incidence of grade II-IV acute graft-versus-host disease (HR, 2.94; P =.0011), and inferior DFS (HR, 1.86; P =.0004). Conditioning intensity was not associated with relapse; however, stable disease/progression was correlated with increased risk of relapse (HR, 2.13; P =.0072). Both in vivo T cell depletion (TCD) as part of conditioning and KPS <90 were associated with worse TRM and inferior DFS. Receipt of total body irradiation had no significant effect on OS, DFS, or TRM. Our data show that reduced-intensity conditioning without in vivo TCD (ie, without antithymocyte globulin or alemtuzumab) before alloHCT was associated with long-term DFS in patients with T-PLL who were age <= 60 years or who had a KPS >90 or chemosensitive disease. (c) 2022 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.
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