| Literature DB >> 35081472 |
Hemant S Murthy1, Kwang Woo Ahn2, Noel Estrada-Merly3, Hassan B Alkhateeb4, Susan Bal5, Mohamed A Kharfan-Dabaja6, Bhagirathbhai Dholaria7, Francine Foss8, Lohith Gowda8, Deepa Jagadeesh9, Craig Sauter10, Muhammad Bilal Abid11, Mahmoud Aljurf12, Farrukh T Awan13, Ulrike Bacher14, Sherif M Badawy15, Minoo Battiwalla16, Chris Bredeson17, Jan Cerny18, Saurabh Chhabra3, Abhinav Deol19, Miguel Angel Diaz20, Nosha Farhadfar21, César Freytes22, James Gajewski23, Manish J Gandhi24, Siddhartha Ganguly25, Michael R Grunwald26, Joerg Halter27, Shahrukh Hashmi28, Gerhard C Hildebrandt29, Yoshihiro Inamoto30, Antonio Martin Jimenez-Jimenez31, Matt Kalaycio9, Rammurti Kamble32, Maxwell M Krem29, Hillard M Lazarus33, Aleksandr Lazaryan34, Joseph Maakaron35, Pashna N Munshi36, Reinhold Munker29, Aziz Nazha9, Taiga Nishihori34, Olalekan O Oluwole7, Guillermo Ortí37, Dorothy C Pan38, Sagar S Patel39, Attaphol Pawarode40, David Rizzieri41, Nakhle S Saba42, Bipin Savani43, Sachiko Seo44, Celalettin Ustun45, Marjolein van der Poel46, Leo F Verdonck47, John L Wagner48, Baldeep Wirk49, Betul Oran50, Ryotaro Nakamura51, Bart Scott52, Wael Saber3.
Abstract
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.Entities:
Keywords: Allogeneic stem cell transplant; Prolymphocytic leukemia; T-PLL
Mesh：
Year: 2022 PMID： 35081472 PMCID： PMC8977261 DOI： 10.1016/j.jtct.2022.01.017
Source DB: PubMed Journal: Transplant Cell Ther ISSN： 2666-6367