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Allogeneic Hematopoietic Cell Transplantation for Adult T Cell Acute Lymphoblastic Leukemia. 2017
Betty Ky Hamilton, and
Lisa Rybicki, and
Donna Abounader, and
Kehinde Adekola, and
Anjali Advani, and
Ibrahim Aldoss, and
Veronika Bachanova, and
Asad Bashey, and
Stacey Brown, and
Marcos DeLima, and
Steven Devine, and
Christopher R Flowers, and
Siddharth Ganguly, and
Madan Jagasia, and
Vanessa E Kennedy, and
Dennis Dong Hwan Kim, and
Joseph McGuirk, and
Vinod Pullarkat, and
Rizwan Romee, and
Karamjeet Sandhu, and
Melody Smith, and
Masumi Ueda, and
Auro Viswabandya, and
Khoan Vu, and
Sarah Wall, and
Simon B Zeichner, and
Miguel-Angel Perales, and
Navneet S Majhail
Blood and Marrow Transplant Program, Cleveland Clinic, Cleveland, Ohio. Electronic address: hamiltb2@ccf.org.
Allogeneic hematopoietic cell transplantation (HCT) is recommended for patients with T cell acute lymphoblastic leukemia (T-ALL) in second or later complete remission (CR) and high-risk patients in first CR. Given its relative rarity, data on outcomes of HCT for T-ALL are limited. We conducted a multicenter retrospective cohort study using data from 208 adult patients who underwent HCT between 2000 and 2014 to describe outcomes of allogeneic HCT for T-ALL in the contemporary era. The median age at HCT was 37 years, and the majority of patients underwent HCT in CR, using total body irradiation (TBI)-based myeloablative conditioning regimens. One-quarter of the patients underwent alternative donor HCT using a mismatched, umbilical cord blood, or haploidentical donor. With a median follow up of 38 months, overall survival at 5 years was 34%. The corresponding cumulative incidence of non-relapse mortality and relapse was 26% and 41%, respectively. In multivariable analysis, factors significantly associated with overall survival were the use of TBI (HR, 0.57; P = .021), age >35 years (HR, 1.55; P = .025), and disease status at HCT (HR, 1.98; P = .005 for relapsed/refractory disease compared with CR). Relapse was the most common cause of death (58% of patients). Allogeneic HCT remains a potentially curative option in selected patients with adult T-ALL, although relapse is a major cause of treatment failure.
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[Rinsho ketsueki] The Japanese journal of clinical hematology,
