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Luo L, Jiao Y, Li Y, Yang P, Gao J, Huang S, Huang W, Wang J, Dong F, Ke X, Zou D, Gao C, Jing H. Efficacy and prognostic factors of allogeneic hematopoietic stem cell transplantation treatment for adolescent and adult Tlymphoblastic leukemia /lymphoma: a large cohort multicenter study in China. Ann Hematol 2024; 103:2073-2087. [PMID: 38581546 DOI: 10.1007/s00277-024-05719-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 03/18/2024] [Indexed: 04/08/2024]
Abstract
T lymphoblastic leukemia /lymphoma (T-ALL/LBL) is a rare and highly aggressive neoplasm of lymphoblasts. We evaluated 195 T-ALL/LBL adolescent and adult patients who received ALL-type chemotherapy alone (chemo,n = 72) or in combination with autologous hematopoietic stem cell transplantation(auto-HSCT,n = 23) or allogeneic hematopoietic stem cell transplantation(allo-HSCT,n = 100) from January 2006 to September 2020 in three Chinese medical centers. 167 (85.6%) patients achieved overall response (ORR) with 138 complete response (CR) patients (70.8%) and 29 partial response (PR) patients (14.8%). Until October 1, 2023, no difference was found in 5-year overall survival (5-OS) and 5-year progression free survival(5-PFS) between allo-HSCT and auto-HSCT (5-OS 57.9% vs. 36.7%, P = 0.139, 5-year PFS 49.4% vs. 28.6%, P = 0.078) for patients who achieved CR, for patients who achieved PR, allo-HSCT recipients had higher 5-OS compared with chemo alone recipients (5-OS 23.8% vs. 0, P = 0.042). For patients undergoing allo-HSCT, minimal residual disease (MRD) negative population showed better 5-OS survival compared with MRD positive patients (67.8% vs. 19.6%, p = 0.000). There were no significant differences between early T-cell precursor (ETP), NON-ETP patients with or without expression of one or more myeloid-associated or stem cell-associated (M/S+) markers (NON-ETP with M/S+, NON-ETP without M/S+) groups in allo-HSCT population for 5-OS. (62.9% vs. 54.5% vs.48.4%, P > 0.05). Notch mutations were more common in patients with non-relapsed/refractory disease than relapsed/refractory disease (χ² =4.293, P = 0.038). In conclusion, Allo-HSCT could be an effective consolidation therapy not just for patients with CR, but also for those who achieved PR. The prognosis is significantly improved by obtaining MRD negative prior to allogeneic transplantation.
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Affiliation(s)
- Lan Luo
- Department of hematology, Peking University Third Hospital, 49 North. Huayuan Road, Beijing, 100191, China
| | - Yang Jiao
- Institute of Hematology and Blood Diseases Hospital, National Clinical Research Center for Blood Diseases, State Key Laboratory of Experimental Hematology, Chinese Academy of Medical Sciences, Tianjin, 300020, China
| | - Yan Li
- Department of hematology, Peking University Third Hospital, 49 North. Huayuan Road, Beijing, 100191, China
| | - Ping Yang
- Department of hematology, Peking University Third Hospital, 49 North. Huayuan Road, Beijing, 100191, China
| | - Jinjie Gao
- Department of hematology, Peking University Third Hospital, 49 North. Huayuan Road, Beijing, 100191, China
| | - Sai Huang
- Department of Hematology, Medical School of Chinese PLA, Chinese People's Liberation Army (PLA) General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Wenyang Huang
- Institute of Hematology and Blood Diseases Hospital, National Clinical Research Center for Blood Diseases, State Key Laboratory of Experimental Hematology, Chinese Academy of Medical Sciences, Tianjin, 300020, China
| | - Jijun Wang
- Department of hematology, Peking University Third Hospital, 49 North. Huayuan Road, Beijing, 100191, China
| | - Fei Dong
- Department of hematology, Peking University Third Hospital, 49 North. Huayuan Road, Beijing, 100191, China
| | - Xiaoyan Ke
- Department of hematology, Peking University Third Hospital, 49 North. Huayuan Road, Beijing, 100191, China
| | - Dehui Zou
- Institute of Hematology and Blood Diseases Hospital, National Clinical Research Center for Blood Diseases, State Key Laboratory of Experimental Hematology, Chinese Academy of Medical Sciences, Tianjin, 300020, China
| | - Chunji Gao
- Department of Hematology, Medical School of Chinese PLA, Chinese People's Liberation Army (PLA) General Hospital, 28 Fuxing Road, Beijing, 100853, China.
| | - Hongmei Jing
- Department of hematology, Peking University Third Hospital, 49 North. Huayuan Road, Beijing, 100191, China.
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2
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Huo W, Gao L, Song K, Huang J, Wang N, Cao L, Liu Y, Wang F, Li C, Zhu X, Wu X, Cao Y, Mo X, Hu X. Allogeneic haematopoietic stem cell transplantation for adult T-lymphoblastic lymphoma: A real-world multicentre analysis in China. Br J Haematol 2024; 204:2390-2399. [PMID: 38664918 DOI: 10.1111/bjh.19481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 04/09/2024] [Indexed: 06/15/2024]
Abstract
In this multicentre, real-world study, we aimed to identify the clinical outcomes and safety of allogeneic haematopoietic stem cell transplantation (allo-HSCT) in T-lymphoblastic lymphoma (T-LBL). A total of 130 Ann Arbor stage III or IV T-LBL patients (>16 years) treated with allo-HSCT across five transplant centres were enrolled. The 2-year cumulative incidence of disease progression, the probabilities of progression-free survival (PFS), overall survival (OS) and non-relapse mortality (NRM) after allo-HSCT were 21.0%, 69.8%, 79.5% and 9.2% respectively. Patients with central nervous system (CNS) involvement had a higher cumulative incidence of disease progression compared with those without CNS involvement (57.1% vs. 18.9%, HR 3.78, p = 0.014). Patients receiving allo-HSCT in non-remission (NR) had a poorer PFS compared with those receiving allo-HSCT in complete remission (CR) or partial remission (49.2% vs. 72.7%, HR 2.21, p = 0.041). Particularly for patients with bone marrow involvement and achieving CR before allo-HSCT, measurable residual disease (MRD) positivity before allo-HSCT was associated with a poorer PFS compared with MRD negativity (62.7% vs. 86.8%, HR 1.94, p = 0.036). On multivariate analysis, CNS involvement at diagnosis and receiving allo-HSCT in NR were associated with disease progression. Thus, our real-world data suggested that allo-HSCT appeared to be an effective therapy for adult T-LBL patients with Ann Arbor stage III or IV disease.
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Affiliation(s)
- Wenxuan Huo
- Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Beijing, China
| | - Lu Gao
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, the First Affiliated Hospital of Soochow University, Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Kaidi Song
- Department of Hematology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Jiayu Huang
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Na Wang
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Leqing Cao
- Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Beijing, China
| | - Yang Liu
- Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Beijing, China
| | - Fengrong Wang
- Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Beijing, China
| | - Chuan Li
- Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Beijing, China
| | - Xiaoyu Zhu
- Department of Hematology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Xiaojin Wu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, the First Affiliated Hospital of Soochow University, Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Yang Cao
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaodong Mo
- Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Beijing, China
| | - Xiaoxia Hu
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Li Z, Zhang B, Fan X, Gui R, Yu F, Wang J, Zhang Y, Zhou K, Liu Y, Li Y, Ding J, Song Y, Zhou J. Selection of hematopoietic stem cell transplantation for T-cell lymphoblastic lymphoma. Front Oncol 2023; 13:1193237. [PMID: 37546390 PMCID: PMC10399448 DOI: 10.3389/fonc.2023.1193237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 07/03/2023] [Indexed: 08/08/2023] Open
Abstract
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.
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Affiliation(s)
- Zhen Li
- Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Binglei Zhang
- Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Xinxin Fan
- Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Ruirui Gui
- Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Fengkuan Yu
- Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Juan Wang
- Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Yanli Zhang
- Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Keshu Zhou
- Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Yanyan Liu
- Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Yufu Li
- Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Jing Ding
- Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Yongping Song
- Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Jian Zhou
- Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, Henan, China
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4
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Luo L, Jiao Y, Yang P, Li Y, Huang WY, Ke XY, Zou DH, Jing HM. [Efficacy and prognostic factors of allogeneic hematopoietic stem cell transplantation treatment for T lymphoblastic leukemia/lymphoma]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2023; 44:388-394. [PMID: 37550188 PMCID: PMC10440623 DOI: 10.3760/cma.j.issn.0253-2727.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Indexed: 08/09/2023]
Abstract
Objective: To analyze the efficacy and prognostic factors of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for treating T lymphoblastic leukemia/lymphoma (T-ALL/LBL) . Methods: This study retrospectively evaluated 119 adolescent and adult patients with T-ALL/LBL from January 2006 to January 2020 at Peking University Third Hospital and Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences. Patients were divided into chemotherapy-only, chemotherapy followed by allo-HSCT, and chemotherapy followed by autologous hematopoietic stem cell transplantation (auto-HSCT) groups according to the consolidation regimen, and the 5-year overall survival (OS) and progression-free survival (PFS) rates of each group were compared. Results: Among 113 patients with effective follow-up, 96 (84.9%) patients achieved overall response (ORR), with 79 (69.9%) having complete response (CR) and 17 (15.0%) having partial response (PR), until July 2022. The analysis of the 96 ORR population revealed that patients without transplantation demonstrated poorer outcomes compared with the allo-HSCT group (5-year OS: 11.4% vs 55.6%, P=0.001; 5-year PFS: 8.9% vs 54.2%, P<0.001). No difference was found in 5-year OS and 5-year PFS between the allo-HSCT and auto-HSCT groups (P=0.271, P=0.197). The same results were achieved in the CR population. Allo-HSCT got better 5-year OS (37.5% vs 0) for the 17 PR cases (P=0.064). Different donor sources did not affect 5-year OS, with sibling of 61.1% vs hap-haploidentical of 63.6% vs unrelated donor of 50.0% (P>0.05). No significant difference was found in the treatment response in the early T-cell precursor acute lymphoblastic leukemia/lymphoma (ETP) and non-ETP populations. The ETP group demonstrated lower 5-year OS compared with the non-ETP group in the chemotherapy alone group (0 vs 12.6%, P=0.045), whereas no significant difference was found between the ETP and non-ETP groups in the allo-HSCT group (75.0% vs 62.9%, P=0.852). Multivariate analysis revealed that high serum lactate dehydrogenase level, without transplantation, and no CR after chemotherapy induction were independently associated with inferior outcomes (P<0.05) . Conclusion: Allo-HSCT could be an effective consolidation therapy for adult and adolescent patients with T-ALL/LBL. Different donor sources did not affect survival. Allo-HSCT may overcome the adverse influence of ETP-ALL/LBL on OS.
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Affiliation(s)
- L Luo
- Department of Hematology, Peking University Third Hospital, Beijing 100191, China
| | - Y Jiao
- Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences, National Clinical Research Center for Blood Diseases, State Key Laboratory of Experimental Hematology, Tianjin 300020, China
| | - P Yang
- Department of Hematology, Peking University Third Hospital, Beijing 100191, China
| | - Y Li
- Department of Hematology, Peking University Third Hospital, Beijing 100191, China
| | - W Y Huang
- Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences, National Clinical Research Center for Blood Diseases, State Key Laboratory of Experimental Hematology, Tianjin 300020, China
| | - X Y Ke
- Department of Hematology, Peking University Third Hospital, Beijing 100191, China
| | - D H Zou
- Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences, National Clinical Research Center for Blood Diseases, State Key Laboratory of Experimental Hematology, Tianjin 300020, China
| | - H M Jing
- Department of Hematology, Peking University Third Hospital, Beijing 100191, China
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5
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Wei R, Fang J, Shi W, Lu X, Wu Y, Jiang S, Zhang A, Liao S, Qin C, Cui G, Xia L. Comparison of efficacies of haploidentical transplantation and matched sibling donor transplantation in treating T-cell lymphoblastic lymphoma. Cancer Med 2023; 12:10499-10511. [PMID: 36992548 DOI: 10.1002/cam4.5786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 01/30/2023] [Accepted: 02/27/2023] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVE To investigate the differences in efficacy and safety between haploidentical donor hematopoietic stem cell transplantation (HID-HSCT) and matched sibling donor HSCT (MSD-HSCT) in patients with T-cell lymphoblastic lymphoma (T-LBL). METHODS In this retrospective analysis, we enrolled 38 patients who had undergone allogeneic HSCT at our institution between 2013 and 2021. The study participants included 28 patients who underwent HID-HSCT and 10 patients who underwent MSD-HSCT. We compared the patient characteristics and treatment effectiveness and safety between the two groups and evaluated potential prognostic variables for patients with T-LBL. RESULTS The median follow-up durations in the HID-HSCT and MSD-HSCT groups were 23.5 (range: 4-111) and 28.5 (range: 13-56) months, respectively. All patients showed full-donor chimerism after hematopoietic stem cell transplantation (HSCT). Except for two patients in the HID-HSCT cohort who developed poor graft function, all patients showed neutrophil and platelet engraftments after HSCT. The cumulative incidences of grades III-IV acute graft-versus-host disease were 37.5% and 28.57% in the HID-HSCT and MSD-HSCT groups, respectively (p = 0.84). The cumulative incidences of limited (34.13% vs. 28.57%, p = 0.82) and extensive (31.22% vs. 37.50%, p = 0.53) chronic graft-versus-host disease did not differ between the two cohorts. In the HID-HSCT and MSD-HSCT cohorts, the estimated 2-year overall survival rates were 70.3% (95% confidence interval [CI]: 54.9%-90.0%) and 56.2% (95% CI: 31.6%-100%), respectively (p = 1.00), and the estimated 2-year progression-free survival (PFS) rates were 48.5% (95% CI: 32.8%-71.6%) and 48.0% (95% CI: 24.6%-93.8%), respectively (p = 0.94). Furthermore, the Cox proportional-hazards model showed that a positive positron emission tomography/computed tomography (PET/CT) status before HSCT in patients who had completed chemotherapy was an independent risk factor for PFS in the multivariate analysis (p = 0.0367). CONCLUSION This study showed that HID-HSCT had comparable effectiveness and safety to MSD-HSCT in treating T-LBL. HID-HSCT could serve as an alternate treatment option for T-LBL in patients without an eligible identical donor. Achievement of the PET/CT-negative status before HSCT may contribute to better survival.
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Affiliation(s)
- Ruowen Wei
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jun Fang
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Shi
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuan Lu
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yingying Wu
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shan Jiang
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ao Zhang
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shanshan Liao
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chunxia Qin
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guohui Cui
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Linghui Xia
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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6
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Zou Q, Ma S, Tian X, Cai Q. Comprehensive view on genetic features, therapeutic modalities and prognostic models in adult T-cell lymphoblastic lymphoma. BLOOD SCIENCE 2022; 4:155-160. [DOI: 10.1097/bs9.0000000000000114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 04/01/2022] [Indexed: 11/25/2022] Open
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7
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Niu J, Chen Z, Gao J, Qiu H, Wan L, Wang Y, Wang W, Tong Y, Huang C, Cai Y, Xu X, Zhou K, Zhang Y, Xia X, Shen C, Wei Y, Chen T, Song X, Yang J. Total Body Irradiation-Based Conditioning Regimen Improved the Survival of Adult Patients With T-Cell Lymphoblastic Lymphoma After Allogeneic Peripheral Blood Stem Cell Transplantation. Cell Transplant 2022; 31:9636897221108890. [PMID: 35801674 PMCID: PMC9272478 DOI: 10.1177/09636897221108890] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is one of the
consolidation modalities for adult patients with T-cell lymphoblastic lymphoma
(T-LBL). However, the optimal conditioning regimen needs to be explored. In the
present study, 40 patients with T-LBL undergoing allo-HSCT were retrospectively
analyzed, including 23/40 (57.5%) with total body irradiation (TBI)–based
conditioning regimen and 17/40 (42.5%) with busulfan (BU)-based regimen.
TBI–based regimen significantly increased the cumulative incidence (CI) of grade
II to IV acute graft-versus-host disease (aGvHD) as compared with BU-based
regimen (13.0% vs 0%, P = 0.000). The relapse risk was
significantly lowered in TBI-based group with a 2-year CI of relapse (CIR) of
9.1% as compared with that of 49.6% in BU-based group (P =
0.008). The 1-year and 2-year non-relapse mortalities (NRMs) for all patients
were 5.0% and 10.3%, respectively. The 1-year and 2-year NRMs were 8.9% and
16.0% in TBI-based group, and 0.00% and 0.00% in BU-based group
(P = 0.140). The 2-year probabilities of overall survival
(OS) and relapse-free survival (RFS) were 83.0% [95% confidence interval,
63.4%–100%] and 74.0% (95% confidence interval, 54.4%–93.6%) in TBI-based group,
which were higher than that of 35.0% (95% confidence interval, 0.0%–72.2%) and
50.0% (95% confidence interval, 24.5%–75.4%) in BU-based group, respectively
(P = 0.020 for OS and P = 0.081 for RFS).
In multivariate analysis, TBI-based regimen significantly reduced the risk of
relapse [subdistribution hazard ratio (SHR) = 0.030, 95% CI, 0.002–0.040,
P = 0.000] and improved the OS [hazard ratio (HR) 0.121,
95% CI, 0.021–0.683, P = 0.017] as an independent prognostic
factor. These results suggested that TBI-based regimen might be an optimal
choice for adult patients with T-LBL undergoing allo-HSCT.
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Affiliation(s)
- Jiahua Niu
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
| | - Zhixiao Chen
- Department of Radiation Therapy, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jie Gao
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
| | - Huiying Qiu
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
| | - Liping Wan
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
| | - Ying Wang
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
| | - Wenwei Wang
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
| | - Yin Tong
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
| | - Chongmei Huang
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
| | - Yu Cai
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
| | - Xiaowei Xu
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
| | - Kun Zhou
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
| | - Ying Zhang
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
| | - Xinxin Xia
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
| | - Chang Shen
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
| | - Yu Wei
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
| | - Tingfeng Chen
- Department of Radiation Therapy, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xianmin Song
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
| | - Jun Yang
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee, Shanghai, China
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Ma YY, Zhang QC, Tan X, Zhang X, Zhang C. T-cell lymphoblastic lymphoma with extensive thrombi and cardiac thrombosis: A case report and review of literature. World J Clin Cases 2021; 9:9607-9616. [PMID: 34877297 PMCID: PMC8610884 DOI: 10.12998/wjcc.v9.i31.9607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/28/2021] [Accepted: 09/10/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND T-lymphoblastic lymphoma (T-LBL), a neoplasm of immature T-cell precursors or lymphoblasts, is a clinically aggressive disease. In general, patients with T-LBL have a poor prognosis and often have high-risk clinical features, such as mediastinal masses, central nervous system infiltration, or other indications of high tumor burden; however, extensive thrombi are not common.
CASE SUMMARY A 27-year-old woman presented to the Department of General Surgery with cervical lymph node enlargement accompanied by cough, wheezing, and palpitation for 3 mo. A complete blood count showed a white blood cell count of 1.6 × 109/L, a hemoglobin concentration of 135 g/L, and a platelet count of 175 × 109/L. A biopsy sample of the lymph node mass indicated T-cell lymphoblastic lymphoma, and the bone marrow immunophenotype indicated early T-cell precursor acute lymphoblastic leukemia (ETP-ALL). Abdominal and chest enhanced computed tomography showed thrombi in the superior vena cava, inferior vena cava, right hepatic vein, azygos vein, and right atrium. The ultrasonic cardiogram showed a thrombus in the right atrium of 5.23 cm × 4.21 cm. The patient was first treated with low-dose dexamethasone and low-molecular-weight heparin followed by 2 cycles of chemotherapy. Then, the ultrasonic cardiogram showed that thrombus in the right atrium had disappeared and the patient had achieved complete cytological remission. The maintenance therapy of the patient included chidamide 30 mg/wk, and she survived for 6 mo.
CONCLUSION The incidence of venous thromboembolism is high in lymphoma; however, extensive thrombi with heart thrombosis is rare. Chemotherapy is the major method of treatment for lymphoma with thrombosis. We successfully treated a patient with T-LBL complicated by extensive thrombi, including a large right atrial thrombus, with combined chemotherapy containing liposomal doxorubicin, and the patient achieved complete remission. Maintenance therapy with chidamide was also effective.
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Affiliation(s)
- Ying-Ying Ma
- Department of Hematology, State Key Laboratory of Trauma, Burns and Combined Injury, Xinqiao Hospital of Army Medical University, Chongqing 400037, China
| | - Quan-Chao Zhang
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing 400037, China
| | - Xu Tan
- Department of Hematology, State Key Laboratory of Trauma, Burns and Combined Injury, Xinqiao Hospital of Army Medical University, Chongqing 400037, China
| | - Xi Zhang
- Department of Hematology, State Key Laboratory of Trauma, Burns and Combined Injury, Xinqiao Hospital of Army Medical University, Chongqing 400037, China
| | - Cheng Zhang
- Department of Hematology, State Key Laboratory of Trauma, Burns and Combined Injury, Xinqiao Hospital of Army Medical University, Chongqing 400037, China
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9
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Chen H, Qin Y, Yang J, Liu P, He X, Zhou S, Zhang C, Yang S, Gui L, Sun Y, Shi Y. Dismal outcome of relapsed or primary refractory adult T-cell lymphoblastic lymphoma: A retrospective study from China. Asia Pac J Clin Oncol 2021; 18:e87-e95. [PMID: 34161657 DOI: 10.1111/ajco.13562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 12/29/2020] [Indexed: 11/27/2022]
Abstract
AIM Little is known about the outcome and prognostic factors of relapsed or refractory T-cell lymphoblastic lymphoma (T-LBL), especially in adult patients. The aim of this study was to analyze the characteristics, outcome and prognostic factors for this patient population. METHODS Between January 2006 and December 2017, we retrospectively analyzed 84 adult patients with T-LBL, and 44 relapsed or primary refractory patients were included in this analysis. Clinical features, treatment and follow-up information were collected. RESULTS For all 44 patients, the median time to disease progression or relapse was 9.5 months after diagnosis. At a median follow-up of 19.6 months, 40 (90.9%) patients died. The 3- and 5-year overall survival (OS) rates after disease progression or relapse were 7.8% and 5.2%, respectively. Among 30 patients who had detailed information of second-line treatment, only eight achieved a second complete remission (CR). Two of these eight patients subsequently underwent autologous or allogeneic stem cell transplantation (SCT), of whom one died from disease progression after autologous SCT, and one was free of event at 84 months after allogeneic SCT. Three of the rest six patients in second CR were still alive after chemotherapy alone. All the remaining patients who failed to gain second CR eventually died. In univariate analysis, only the achievement of second CR was positively predictive of OS (hazard ratio (HR) = 0.307; 95% confidence interval (CI), 0.104-0.905; P = 0.032). CONCLUSION The outcome of adult patients with relapsed or refractory T-LBL is extremely dismal. Patients with relapsed or refractory T-LBL should be encouraged to participate in clinical trials where novel therapeutic approaches are available.
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Affiliation(s)
- Haizhu Chen
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, China
| | - Yan Qin
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, China
| | - Jianliang Yang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, China
| | - Peng Liu
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, China
| | - Xiaohui He
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, China
| | - Shengyu Zhou
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, China
| | - Changgong Zhang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, China
| | - Sheng Yang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, China
| | - Lin Gui
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, China
| | - Yan Sun
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, China
| | - Yuankai Shi
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, China
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10
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Yasuda S, Najima Y, Konishi T, Yamada Y, Nagata A, Takezaki T, Kaito S, Kurosawa S, Sakaguchi M, Harada K, Shingai N, Yoshioka K, Inamoto K, Mukae J, Toya T, Igarashi A, Shimizu H, Kobayashi T, Kakihana K, Sakamaki H, Kawamata N, Ohashi K, Doki N. Outcome of allogeneic hematopoietic stem cell transplantation for T-cell lymphoblastic leukemia/lymphoma: A single-center study. Leuk Res 2021; 108:106627. [PMID: 34062327 DOI: 10.1016/j.leukres.2021.106627] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 05/13/2021] [Accepted: 05/16/2021] [Indexed: 01/07/2023]
Abstract
Although the indications for allogeneic hematopoietic stem cell transplantation (allo-HSCT) as a treatment for T-cell acute lymphoblastic leukemia/lymphoma (T-ALL/LBL) and Philadelphia chromosome (Ph)-negative B-cell acute lymphoblastic leukemia (B-ALL) are similar, few studies have compared its outcomes for T-ALL/LBL and Ph-negative B-ALL. The clinical data of 28 patients with T-ALL, 16 with T-LBL, and 99 with Ph-negative B-ALL who underwent the first allo-HSCT from 2000 to 2019 were retrospectively analyzed. Complete remission (CR) rates at allo-HSCT were 79 %, 63 %, and 75 % for T-ALL, T-LBL, and B-ALL, respectively; the 3-year overall survival (OS) rates were 55.7 %, 56.2 %, and 58.6 %, respectively (p = 0.92). Univariate analysis revealed that disease subtypes were not significantly associated with OS (B-ALL vs. T-ALL: hazard ratio [HR]=0.89, p = 0.70; T-LBL vs. T-ALL: HR=0.87, p = 0.75), and CR at allo-HSCT was the only prognostic factor for OS (HR=0.25, p < 0.001). Multivariate analysis demonstrated that CR at allo-HSCT was the only predictor of OS (HR=0.24, p < 0.001). In all three disease subtypes, patients in CR at allo-HSCT tended to have a lower cumulative incidence of relapse than did those in non-CR (T-ALL: 13.6 % vs. 50.0 %, p = 0.10; T-LBL: 20.0 % vs. 50.0 %, p = 0.21; B-ALL: 10.0 % vs. 56.0 %, p < 0.01). Thus, the outcomes of allo-HSCT for T-ALL/LBL were comparable to those of Ph-negative B-ALL. Irrespective of the disease subtypes, achieving CR before allo-HSCT was associated with a favorable OS. Further advances in chemotherapy before allo-HSCT and defining the optimal timing of allo-HSCT would improve the prognosis of patients with T-ALL/LBL.
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Affiliation(s)
- Shunichiro Yasuda
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan; Department of Immunotherapy for Hematopoietic Disorders, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuho Najima
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.
| | - Tatsuya Konishi
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Yuta Yamada
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Akihito Nagata
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Toshiaki Takezaki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Satoshi Kaito
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Shuhei Kurosawa
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Masahiro Sakaguchi
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Kaito Harada
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Naoki Shingai
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Kosuke Yoshioka
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Kyoko Inamoto
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Junichi Mukae
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Takashi Toya
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Aiko Igarashi
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Hiroaki Shimizu
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Takeshi Kobayashi
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Kazuhiko Kakihana
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Hisashi Sakamaki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Norihiko Kawamata
- Department of Immunotherapy for Hematopoietic Disorders, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kazuteru Ohashi
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Noriko Doki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
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11
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Treatment and Outcome Analysis of 639 Relapsed Non-Hodgkin Lymphomas in Children and Adolescents and Resulting Treatment Recommendations. Cancers (Basel) 2021; 13:cancers13092075. [PMID: 33923026 PMCID: PMC8123268 DOI: 10.3390/cancers13092075] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/18/2021] [Accepted: 04/22/2021] [Indexed: 12/23/2022] Open
Abstract
Simple Summary Despite very poor survival, controversies remain in the treatment for refractory or relapsed non-Hodgkin lymphoma (r/r NHL) in children and adolescents. The current project identifies and reports international experience on re-induction treatment of r/r NHL, hematopoietic stem cell transplantation, risk factors associated with outcome, and suggests treatment recommendations. Abstract Despite poor survival, controversies remain in the treatment for refractory or relapsed pediatric non-Hodgkin lymphoma (r/r NHL). The current project aimed to collect international experience on the re-induction treatment of r/r NHL, hematopoietic stem cell transplantation (HSCT), risk factors associated with outcome, and to suggest treatment recommendations. Inclusion criteria were (i) refractory disease, disease progression or relapse of any NHL subtype except anaplastic large cell lymphoma, (ii) age < 18 years at initial diagnosis, (iii) diagnosis in/after January 2000. Data from 639 eligible patients were evaluable. The eight-year probability of overall survival was 34 ± 2% with highly significant differences according to NHL subtypes: 28 ± 3% for 254 Burkitt lymphoma/leukemia, 50 ± 6% for 98 diffuse large B-cell lymphomas, 57 ± 8% for 41 primary mediastinal large B-cell lymphomas, 27 ± 3% for 177 T-lymphoblastic lymphomas, 52 ± 10% for 34 precursor-B-cell lymphoblastic lymphomas and 30 ± 9% for 35 patients with rare NHL subtypes. Subtype-specific factors associated with survival and treatment recommendations are suggested. There were no survivors without HSCT, except in few very small subgroups. Conclusions: There is an urgent need to further improve survival in r/r NHL. The current study provides the largest real-world series, which underlines the role of HSCT and suggests treatment recommendations.
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Yang Q, Zhou Y, Wang T, Cai P, Fu W, Wang J, Li X. MiRNA-1271-5p regulates osteogenic differentiation of human bone marrow-derived mesenchymal stem cells by targeting forkhead box O1 (FOXO1). Cell Biol Int 2021; 45:1468-1476. [PMID: 33675274 DOI: 10.1002/cbin.11585] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 02/03/2021] [Accepted: 02/27/2021] [Indexed: 12/13/2022]
Abstract
Forkhead box O1 (FOXO1) is a key regulator of osteogenesis. The aim of this study was to identify the mechanisms of microRNAs (miRNAs) targeting FOXO1 in osteogenic differentiation of human bone marrow mesenchymal stem cells (hMSCs). Three miRNA target prediction programs were used to search for potential miRNAs that target FOXO1. Quantitative real-time polymerase chain reaction was conducted to detect the expression of miR-1271-5p and FOXO1 during osteogenic differentiation. Target gene prediction and screening, luciferase reporter assay was used to verify the downstream target gene of miR-1271-5p. The expression levels of FOXO1 and Runx2 were detected by RT-qPCR and Western blot analysis. Alkaline phosphatase (ALP) activity and matrix mineralization were detected by biochemical methods. The expression levels of Runx2, ALP, and osteocalcin were detected by RT-qPCR. Our results showed that miR-1271-5p was downregulated during osteogenic induction. And the expression levels of miR-1271-5p were higher in osteoporotic tissues than that in adjacent nonosteoporotic tissues. The expression levels of FOXO1 were lower in osteoporotic tissues than that in adjacent nonosteoporotic tissues. And a negative correlation was found between miR-1271-5p and FOXO1 in osteoporotic tissues. Overexpression of miR-1271-5p downregulated FOXO1 and inhibited osteogenic differentiation in hMSCs. Overexpression of miR-1271-5p downregulated the expression of osteogenic markers and reduced ALP activity. In addition, ectopic expression of FOXO1 reversed the effect of miR-1271-5p on osteogenic differentiation. In conclusion, miR-1271-5p functioned as a therapeutic target of osteogenic differentiation in hMSCs by inhibiting FOXO1, which provides valuable insights into the use of miR-1271-5p as a target in the treatment of osteoporosis and other bone metabolic diseases.
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Affiliation(s)
- Qining Yang
- Department of Joint surgery, The affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua City, Zhejiang Province, China
| | - Yongwei Zhou
- Department of Joint surgery, The affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua City, Zhejiang Province, China
| | - Tianbao Wang
- Department of Joint surgery, The affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua City, Zhejiang Province, China
| | - Pengfei Cai
- Department of Joint surgery, The affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua City, Zhejiang Province, China
| | - Weicong Fu
- Department of Joint surgery, The affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua City, Zhejiang Province, China
| | - Jinhua Wang
- Department of Joint surgery, The affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua City, Zhejiang Province, China
| | - Xiaofei Li
- Department of Joint surgery, The affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua City, Zhejiang Province, China
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13
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Liu Y, Rao J, Li J, Wen Q, Wang S, Lou S, Yang T, Li B, Gao L, Zhang C, Kong P, Gao L, Wang M, Zhu L, Xiang X, Zhou S, Liu X, Peng X, Zhong J, Zhang X. Tandem autologous hematopoietic stem cell transplantation for treatment of adult T-cell lymphoblastic lymphoma: a multiple center prospective study in China. Haematologica 2021; 106:163-172. [PMID: 31780634 PMCID: PMC7776263 DOI: 10.3324/haematol.2019.226985] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 11/26/2019] [Indexed: 11/27/2022] Open
Abstract
T-cell lymphoblastic lymphoma (T-LBL) is a highly aggressive form of lymphoma with poor clinical outcomes and no standard treatment regimen. In this study, we assessed the safety and efficacy of tandem autologous hematopoietic stem cell transplantation (auto-HSCT) for adult T-LBL and evaluated prognostic factors affecting survival. A total of 181 newly-diagnosed adult T-LBL patients were enrolled: 89 patients were treated with chemotherapy alone, 46 were allocated to the single auto-HSCT group, 46 were treated with tandem auto-HSCT. Median follow-up time was 37 months; the 3-year progression/relapse rate of the tandem auto- HSCT group was significantly lower than that of the single auto-HSCT and chemotherapy groups (26.5% vs. 53.1% and 54.8%). The 3-year progression- free survival (PFS) and overall survival (OS) rates of the tandem auto- HSCT group (73.5% and 76.3%) were significantly higher than those of the single auto-HSCT group (46.9% and 58.3%) and the chemotherapy group (45.1% and 57.1%). In the tandem auto-HSCT group, age and disease status after the first transplant impacted OS and PFS. Multivariate analysis identified that disease status after the first transplant was the only independent prognostic factor for patients treated with tandem-HSCT. In addition, diagnostic models of the initial CD8+CD28+/CD8+CD28– T-cell ratio in predicting the disease status were found to be significant. Taken together, tandem auto- HSCT can be considered an optimal strategy for adult T-LBL patients. (Study registered at: ChiCTR-ONN-16008480).
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Affiliation(s)
- Yao Liu
- Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Jun Rao
- Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing
| | - Jiali Li
- Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Qin Wen
- Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Sanbin Wang
- Dept. Hematology, General Hospital of Kunming Military Region of People Liberation Army, Kunming
| | - Shifeng Lou
- Department of Hematology, Second Affiliated Hospital of Chongqing Medical University,Chongqing,China
| | - Tonghua Yang
- Department of Hematology, Yunan Provincial People Hospital, Kunming, China
| | - Bin Li
- Department of Hematology, Second Yunnan Provincial People Hospital, Yunnan, China
| | - Lei Gao
- Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Cheng Zhang
- Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Peiyan Kong
- Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing
| | - Li Gao
- Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Maihong Wang
- Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Lidan Zhu
- Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Xixi Xiang
- Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Sha Zhou
- Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Xue Liu
- Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Xiangui Peng
- Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Jiangfan Zhong
- Department of Pathology, University of Southern California, Keck School of Medicine
| | - Xi Zhang
- Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing, China
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14
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Indication and benefit of upfront hematopoietic stem cell transplantation for T-cell lymphoblastic lymphoma in the era of ALL-type induction therapies. Sci Rep 2020; 10:21418. [PMID: 33293600 PMCID: PMC7722931 DOI: 10.1038/s41598-020-78334-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 11/23/2020] [Indexed: 12/24/2022] Open
Abstract
Since the introduction of leukemia-type induction therapies for T-cell lymphoblastic lymphoma (T-LBL), improvements in the long-term outcomes of T-LBL have been reported. However, indications for and the appropriate timing of hematopoietic stem cell transplantation (HSCT) have not yet been established. Therefore, we performed a multicenter retrospective cohort study of patients with T-LBL treated using leukemia-type initial therapies to compare the outcomes after HSCT at different disease stages. We enrolled 21 patients with T-LBL from a total of 11 centers, and all patients received hyper-CVAD as a leukemia-type initial regimen. HSCT was performed during the CR1/PR1 (standard disease) stage in 11 patients, while it was completed at a later or non-remission (advanced disease) stage in 10 patients. Following HSCT, the overall survival rate was significantly greater in standard disease than in advanced-disease patients (79.5% vs. 30.0% at 5 years; hazard ratio (HR) 5.97; p = 0.03), with trend to the lower incidence of relapse in the former group (27.3% vs. 60.0% at 5 years; HR 2.29; p = 0.19). A prognostic difference was not detected between cases treated with allogeneic and autologous HSCTs. Our study suggests that frontline HSCT may be a feasible treatment option for T-LBL, even in the era of leukemia-type initial therapy.
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15
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Wang HT, Dong Y, Gao XT, Wan Z, Zhao YX, Liu YM, Liu L. [Analysis of treatment response and prognostic factors of T-LBL patients treated with pediatric-like ALL therapy following HSCT]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2020; 41:387-393. [PMID: 32536135 PMCID: PMC7342060 DOI: 10.3760/cma.j.issn.0253-2727.2020.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
目的 探讨经急性淋巴细胞白血病(ALL)儿童方案治疗达到完全缓解(CR)和部分缓解(PR)的T淋巴母细胞淋巴瘤(T-LBL)患者应用造血干细胞移植巩固治疗的疗效及预后因素。 方法 收集2013年1月至2017年1月于唐都医院血液病中心接受治疗的T-LBL患者的临床资料,将达到CR或PR的患者纳入研究,进行回顾性分析。 结果 ①48例患者接受了ALL儿童方案治疗,经2个疗程的诱导化疗后39例达CR,9例达PR。其中接受自体造血干细胞移植(auto-HSCT)者14例,接受异基因造血干细胞移植(allo-HSCT)者7例,21例患者移植后造血功能均顺利重建。②中位随访时间31(9~16)个月。3年总生存(OS)率为61.0%(95% CI 53.7%~68.3%),3年无进展生存(PFS)率为54.8%(95% CI 47.1%~62.2%)。③移植组和未移植组3年OS率分别为84.7%和42.8%(P=0.006),两组3年PFS率分别为75.4%和38.9%(P=0.004)。④auto-HSCT组与allo-HSCT组患者的OS率、PFS率差异均无统计学意义(P值分别为0.320、0.597)。⑤骨髓侵犯、未接受造血干细胞移植是影响患者长期预后的独立危险因素[ HR=5.804(95% CI 1.140~29.549),P=0.034;HR=5.871(95% CI 1.711~20.140),P=0.005]。 结论 ALL儿童方案化疗序贯造血干细胞移植治疗T-LBL疗效确切,安全性好。auto-HSCT与allo-HSCT患者的OS率及PFS率差异均无统计学意义。骨髓侵犯、未接受造血干细胞移植是影响T-LBL患者长期预后的独立危险因素。
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Affiliation(s)
- H T Wang
- Department of Hematology, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China
| | - Y Dong
- Department of Hematology, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China
| | - X T Gao
- Department of Hematology, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China
| | - Z Wan
- Department of Hematology, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China
| | - Y X Zhao
- Department of Hematology, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China
| | - Y M Liu
- Department of Nutrition and Food Safety, Xi'an Jiaotong University, Xi'an 710049, China
| | - L Liu
- Department of Hematology, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China
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16
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Gardenswartz A, Cairo MS. Hematopoietic Progenitor Cell Transplantation in Children, Adolescents, and Young Adults With Relapsed Mature B-Cell NHL. J Natl Compr Canc Netw 2020; 18:1135-1142. [PMID: 32755988 DOI: 10.6004/jnccn.2020.7617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 07/07/2020] [Indexed: 11/17/2022]
Abstract
Although children, adolescents, and young adults with newly diagnosed B-cell non-Hodgkin's lymphoma enjoy excellent overall survival with current chemoimmunotherapy, those with relapsed and/or refractory disease have a dismal prognosis. Although most clinicians would agree that hematopoietic progenitor cell transplantation after reinduction therapy is frontline therapy for these patients, there is no consensus as to what type of hematopoietic progenitor cell transplantation promises the best event-free and overall survival. This review outlines the disparate types of stem cell therapy that have been used in this difficult-to-treat population as well as the role of maintenance and CAR T-cell therapy in conjunction with stem cell therapy.
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Affiliation(s)
| | - Mitchell S Cairo
- Departments of Pediatrics.,Pathology.,Medicine.,Microbiology and Immunology, and.,Cell Biology and Anatomy, Maria Fareri Children's Hospital at Westchester Medical Center, New York Medical College, Valhalla, New York
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17
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Lu JP, Wang FX, Wen SP, Liu X, Wang Y, Niu ZY, Zhang XJ. Haploidentical hematopoietic stem cell transplantation with 'Beijing protocol' in the treatment of T-lymphoblastic lymphoma. Leuk Lymphoma 2020; 61:2748-2751. [PMID: 32543937 DOI: 10.1080/10428194.2020.1775205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Jia-Pei Lu
- Department of Hematology, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Hematology, Shijiazhuang, China
| | - Fu-Xu Wang
- Department of Hematology, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Hematology, Shijiazhuang, China
| | - Shu-Peng Wen
- Department of Hematology, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Hematology, Shijiazhuang, China
| | - Xuan Liu
- Department of Hematology, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Hematology, Shijiazhuang, China
| | - Ying Wang
- Department of Hematology, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Hematology, Shijiazhuang, China
| | - Zhi-Yun Niu
- Department of Hematology, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Hematology, Shijiazhuang, China
| | - Xue-Jun Zhang
- Department of Hematology, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Hematology, Shijiazhuang, China
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18
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Wang P, Li CX, Zhang Y, Chen J, Chen XC, Yang D, Zhou J, Zong XP, Yang Z, Wu M, Yang MZ, Song YQ, Zhu J, Wu DP. [Autologous hematopoietic stem cell transplantation treatment for T cell lymphoblastic lymphoma]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2020; 41:198-203. [PMID: 32311888 PMCID: PMC7357929 DOI: 10.3760/cma.j.issn.0253-2727.2020.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
目的 探讨自体造血干细胞移植(auto-HSCT)巩固治疗T淋巴母细胞淋巴瘤(T-LBL)的疗效及相关影响因素。 方法 对2006年4月至2017年7月在苏州大学附属第一医院血液科和北京大学肿瘤医院淋巴瘤科接受auto-HSCT的41例T-LBL患者进行回顾性分析。 结果 ①41例T-LBL患者中,男30例,女11例,中位年龄24(11~53)岁,12例(29.3%)纵隔累及,20例(48.8%)骨髓累及,Ann Arbor分期Ⅲ期及以上33例(80.5%);移植前疾病处于第1次完全缓解(CR1)期26例(63.4%),非CR1期15例(36.6%);移植前国际预后指数(IPI)中低危组(<3分)29例(70.7%),中高危组(≥3分)12例(29.3%)。②移植后中位随访29(3~98)个月,全部41例患者的3年总生存(OS)率、无进展生存(PFS)率分别为(64.3±8.2)%、(66.0±7.8)%,3年累积复发率(CIR)为(30.7±7.4)%,3年非复发死亡率(NRM)为(4.8±4.6)%。③CR1组、非CR1组患者3年OS率分别为(83.4±7.6)%、(38.9±12.9)%(P=0.010),3年PFS率分别为(83.8±7.4)%、(40.0±12.6)%(P=0.006),3年CIR分别为(16.2±7.4)%、(53.3±12.9)%(P=0.015),3年NRM分别为0、(14.3±13.2)%(P=0.157)。④IPI中低危组、中高危组3年OS率分别为(76.9±8.4)%、(35.7±15.2)%(P=0.014),3年PFS率分别为(77.4±8.2)%、(40.0±14.6)%(P=0.011),3年CIR分别为(18.1±7.3)%、(60.0±14.6)%(P=0.006),3年NRM分别为(5.6±5.4)%、0(P=0.683)。 结论 auto-HSCT可显著改善T-LBL患者的预后,移植前疾病状态和IPI评分是影响auto-HSCT疗效的重要因素。
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Affiliation(s)
- P Wang
- Department of Hematology, The First Affiliiliated Hospital of Soochow University, Jiangsu Insititute of Hematology, Suzhou 215006, China
| | - C X Li
- Department of Hematology, The First Affiliiliated Hospital of Soochow University, Jiangsu Insititute of Hematology, Suzhou 215006, China
| | - Y Zhang
- Department of Hematology, The First Affiliiliated Hospital of Soochow University, Jiangsu Insititute of Hematology, Suzhou 215006, China
| | - J Chen
- Department of Hematology, The First Affiliiliated Hospital of Soochow University, Jiangsu Insititute of Hematology, Suzhou 215006, China
| | - X C Chen
- Department of Hematology, The First Affiliiliated Hospital of Soochow University, Jiangsu Insititute of Hematology, Suzhou 215006, China
| | - D Yang
- Department of Hematology, The First Affiliiliated Hospital of Soochow University, Jiangsu Insititute of Hematology, Suzhou 215006, China
| | - J Zhou
- Department of Hematology, The First Affiliiliated Hospital of Soochow University, Jiangsu Insititute of Hematology, Suzhou 215006, China
| | - X P Zong
- Department of Hematology, The First Affiliiliated Hospital of Soochow University, Jiangsu Insititute of Hematology, Suzhou 215006, China
| | - Z Yang
- Department of Hematology, The First Affiliiliated Hospital of Soochow University, Jiangsu Insititute of Hematology, Suzhou 215006, China
| | - M Wu
- Department of Lymphoma, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education) , Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - M Z Yang
- Department of Lymphoma, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education) , Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Y Q Song
- Department of Lymphoma, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education) , Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - J Zhu
- Department of Lymphoma, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education) , Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - D P Wu
- Department of Hematology, The First Affiliiliated Hospital of Soochow University, Jiangsu Insititute of Hematology, Suzhou 215006, China
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19
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Mitsui T, Fujita N, Koga Y, Fukano R, Osumi T, Hama A, Koh K, Kakuda H, Inoue M, Fukuda T, Yabe H, Takita J, Shimada A, Hashii Y, Sato A, Atsuta Y, Kanda Y, Suzumiya J, Kobayashi R. The effect of graft-versus-host disease on outcomes after allogeneic stem cell transplantation for refractory lymphoblastic lymphoma in children and young adults. Pediatr Blood Cancer 2020; 67:e28129. [PMID: 31876367 DOI: 10.1002/pbc.28129] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 11/27/2019] [Accepted: 11/27/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND Patients with relapsed or refractory lymphoblastic lymphoma (LBL) have a poor prognosis. The efficacy of allogeneic blood stem cell transplantation for treatment of this disease remains unclear in terms of transplantation-related toxicity. Acute and chronic graft-versus-host diseases (GVHD) are both harmful to patients after allogeneic transplantation, but may have some positive effects through a substitute graft-versus-lymphoma effect. METHODS To investigate the effect of GVHD on the survival of patients with refractory LBL, we retrospectively studied the outcomes of 213 patients with LBL who underwent first allogeneic stem cell transplantation before the age of 18 years, between 1990 and 2015 in Japan. RESULTS The five-year overall survival (OS) and event-free survival rates after stem cell transplantation were 50.3% (95% confidence interval [CI], 43.2-56.9) and 47.8% (95% CI, 40.8-54.4), respectively. In univariate landmark analyses, the probability of OS was significantly better in patients with aGVHD than in those without (P = 0.002, five-year OS 58.1% vs 39.0%). The probability of OS was also better in patients with cGVHD than in those without (P = 0.036, five-year OS 72.2% vs 54.7%). Multivariate analysis demonstrated that only aGVHD was associated with better OS (hazard ratio, 0.63; 95% CI, 0.42-0.94, P = 0.024). Progression and recurrence statuses at SCT were associated with poor prognosis. The patients with grade II aGVHD showed the best prognosis (five-year OS: 65.6%). CONCLUSION Our results suggest that the occurrence of aGVHD may be associated with better outcomes in patients with relapsed/refractory LBL who undergo allogeneic transplantation.
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Affiliation(s)
- Tetsuo Mitsui
- Department of Pediatrics, Yamagata University Hospital, Yamagata, Japan
| | - Naoto Fujita
- Department of Pediatrics, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Hiroshima, Japan
| | - Yuhki Koga
- Department of Pediatric Medicine for Hospital Collaboration, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Reiji Fukano
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Tomoo Osumi
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Asahito Hama
- Department of Hematology and Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
| | - Katsuyoshi Koh
- Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan
| | - Harumi Kakuda
- Department of Hematology and Oncology, Chiba Children's Hospital, Chiba, Japan
| | - Masami Inoue
- Department of Hematology/Oncology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - Takahiro Fukuda
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Hiromasa Yabe
- Department of Cell Transplantation and Regenerative Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Junko Takita
- Department of Pediatrics, Kyoto University Hospital, Kyoto, Japan
| | - Akira Shimada
- Department of Pediatrics, Okayama University Hospital, Okayama, Japan
| | - Yoshiko Hashii
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Atsushi Sato
- Department of Hematology/Oncology, Miyagi Children's Hospital, Sendai, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshinobu Kanda
- Division of Hematology, Jichi Medical University, Saitama Medical Center, Saitama, Japan
| | - Junji Suzumiya
- Innovative Cancer Center/Oncology-Hematology, Shimane University Hospital Cancer Center, Izumo, Japan
| | - Ryoji Kobayashi
- Department of Pediatrics, Sapporo Hokuyu Hospital, Sapporo, Japan
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20
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Chu Y, Gardenswartz A, Termuhlen AM, Cairo MS. Advances in cellular and humoral immunotherapy - implications for the treatment of poor risk childhood, adolescent, and young adult B-cell non-Hodgkin lymphoma. Br J Haematol 2019; 185:1055-1070. [PMID: 30613939 PMCID: PMC6555680 DOI: 10.1111/bjh.15753] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Patients with relapsed, refractory or advanced stage B non-Hodgkin lymphoma (NHL) continue to have a dismal prognosis. This review summarises current and novel cellular and immunotherapy for these high-risk populations, including haematopoietic stem cell transplant, bispecific antibodies, viral-derived cytotoxic T cells, chimeric antigen receptor (CAR) T cells, and natural killer (NK) cell therapy, as discussed at the 6th International Symposium on Childhood, Adolescent and Young Adult Non-Hodgkin Lymphoma on September 26th-29th 2018 in Rotterdam, the Netherlands, and explores the future of NK/CAR NK therapies.
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Affiliation(s)
- Yaya Chu
- Department of Pediatrics, New York Medical College, Valhalla, NY, USA
| | | | - Amanda M. Termuhlen
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Mitchell S. Cairo
- Department of Pediatrics, New York Medical College, Valhalla, NY, USA
- Department of Medicine, New York Medical College, Valhalla, NY, USA
- Department of Pathology, New York Medical College, Valhalla, NY, USA
- Department of Microbiology & Immunology, New York Medical College, Valhalla, NY, USA
- Department of Cell Biology & Anatomy, New York Medical College, Valhalla, NY, USA
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21
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Prognostic and predictive value of a microRNA signature in adults with T-cell lymphoblastic lymphoma. Leukemia 2019; 33:2454-2465. [PMID: 30953029 DOI: 10.1038/s41375-019-0466-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 02/25/2019] [Accepted: 03/22/2019] [Indexed: 02/06/2023]
Abstract
New prognostic factors are needed to establish indications for haematopoietic stem cell transplantation (HSCT) in first complete remission (CR1) for T-cell lymphoblastic lymphoma (T-LBL) patients. We used microarray to compare T-LBL tissue samples (n = 75) and fetal thymus tissues (n = 20), and identified 35 differentially expressed miRNAs. Using 107 subjects as the training group, we developed a five-miRNA-based classifier to predict patient survival with LASSO Cox regression: lower risk was associated with better prognosis (disease-free survival (DFS): hazard ratio (HR) 4.548, 95% CI 2.433-8.499, p < 0.001; overall survival (OS): HR 5.030, 95% CI 2.407-10.513, p < 0.001). This classifier displayed good performance in the internal testing set (n = 106) and the independent external set (n = 304). High risk was associated with more favorable response to HSCT (DFS: HR 1.675, 95% CI 1.127-2.488, p = 0.011; OS: HR 1.602, 95% CI 1.055-2.433, p = 0.027). When combined with ECOG-PS and/or NOTCH1/FBXW7 status, this classifier had even better prognostic performance in patients receiving HSCT (DFS: HR 2.088, 95% CI 1.290-3.379, p = 0.003; OS: HR 1.996, 95% CI 1.203-3.311, p = 0.007). The five-miRNA classifier may be a useful prognostic biomarker for T-LBL adults, and could identify subjects who could benefit from HSCT.
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22
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Fujita N, Kobayashi R, Atsuta Y, Iwasaki F, Suzumiya J, Sasahara Y, Inoue M, Koh K, Hori T, Goto H, Ichinohe T, Hashii Y, Kato K, Suzuki R, Mitsui T. Hematopoietic stem cell transplantation in children and adolescents with relapsed or refractory B-cell non-Hodgkin lymphoma. Int J Hematol 2019; 109:483-490. [PMID: 30701466 DOI: 10.1007/s12185-019-02608-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 01/19/2019] [Accepted: 01/23/2019] [Indexed: 01/03/2023]
Abstract
We undertook a retrospective study using the national registry data of hematopoietic stem cell transplantation (HSCT) in Japan to investigate the effect of graft source, particularly autologous or allogeneic tissue, on the treatment outcome in patients aged less than 18 years with relapsed or refractory B-cell non-Hodgkin lymphoma (B-NHL). Survival analysis was conducted on 31 autologous HSCT (auto-HSCT) and 48 allogeneic HSCT (allo-HSCT) recipients between 1990 and 2013. The 5-year survival rates were significantly lower for allo-HSCT compared to auto-HSCT recipients (32% vs. 55%; P = 0.036). Multivariate analysis of survival rates identified allogeneic graft, Burkitt histology, and lack of response to chemotherapy as poor prognostic factors for survival. The cumulative incidence of treatment-related mortality (TRM) was significantly higher in allo-HSCT compared to auto-HSCT recipients (P = 0.017), explaining the difference in survival rates. In patients with Burkitt lymphoma (BL), overall survival was significantly inferior in the group of patients undergoing HSCT within 12 months from the initial diagnosis (P = 0.039). These data indicate that treatment outcomes for HSCT in children and adolescents with B-NHL were better in autograft recipients, suggesting that greater attention should be paid to the risk of TRM, especially after allografts, for patients with BL.
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Affiliation(s)
- Naoto Fujita
- Department of Pediatrics, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-Machi, Naka-ku, Hiroshima, 730-8619, Japan.
| | - Ryoji Kobayashi
- Department of Pediatrics, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Fuminori Iwasaki
- Department of Hematology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Junji Suzumiya
- Department of Oncology/Hematology, Shimane University Hospital, Izumo, Japan
| | - Yoji Sasahara
- Department of Pediatrics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masami Inoue
- Department of Hematology/Oncology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - Katsuyoshi Koh
- Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan
| | - Tsukasa Hori
- Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hiroaki Goto
- Division of Hemato-Oncology/Regenerative Medicine, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Tatsuo Ichinohe
- Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Yoshiko Hashii
- Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Koji Kato
- Department of Hematology and Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
| | - Ritsuro Suzuki
- Department of Oncology and Hematology, Shimane University Hospital Cancer Center, Izumo, Japan
| | - Tetsuo Mitsui
- Department of Pediatrics, Yamagata University School of Medicine, Yamagata, Japan
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23
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Abstract
Lymphomas in adolescents and young adults represent approximately one quarter of all cancers in this age group. Historically, adolescent and young adult cancer patients represent a unique population with diverging issues surrounding psychosocial hardships/barriers, economics, and lack of standardization of therapeutic approaches.Furthermore, the biologic differences within the adolescent and young adult population seen in various lymphoma subtypes likely play a role in overall outcomes for this group. Without an organized approach to clinical and translational research for adolescent and young adult patients within specialized treatment centers, this population may continue to experience inferior results. Here we look at the current perspectives of adolescent and young adult lymphomas with respect to disease biology, clinical characteristics, treatment, and prognosis of this unique lymphoma population.
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24
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Hochberg J, Flower A, Brugieres L, Cairo MS. NHL in adolescents and young adults: A unique population. Pediatr Blood Cancer 2018; 65:e27073. [PMID: 29741220 DOI: 10.1002/pbc.27073] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 02/07/2018] [Accepted: 03/04/2018] [Indexed: 12/21/2022]
Abstract
Non-Hodgkin lymphoma (NHL) is a heterogeneous group of lymphoid malignancies with high incidence in adolescents and young adults (AYAs). The most common diseases include diffuse large B-cell lymphoma, anaplastic large cell lymphoma, Burkitt lymphoma, lymphoblastic lymphoma, and primary mediastinal large B-cell lymphoma. In comparison to younger children and adults, AYAs (15-39 years) with NHL present a specific set of challenges including variations in tumor biology, inconsistent treatment, pharmacodynamics, and psychosocial barriers. While survival of AYAs with NHL has improved, cure rates remain suboptimal. Incorporation of novel agents into pediatric-inspired treatment regimens specifically designed for NHL in AYAs has led to improved outcomes. Consideration of AYAs as a distinct population in the diagnosis and treatment of NHL is encouraged.
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Affiliation(s)
- Jessica Hochberg
- Department of Pediatrics, New York Medical College, Valhalla, New York
| | - Allyson Flower
- Department of Pediatrics, New York Medical College, Valhalla, New York.,Department of Microbiology & Immunology, New York Medical College, Valhalla, New York
| | | | - Mitchell S Cairo
- Department of Pediatrics, New York Medical College, Valhalla, New York.,Department of Microbiology & Immunology, New York Medical College, Valhalla, New York.,Department of Medicine, New York Medical College, Valhalla, New York.,Department of Pathology, New York Medical College, Valhalla, New York.,Department of Cell Biology & Anatomy, New York Medical College, Valhalla, New York
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Hu M, Wang H, Wang L, Yang M, Lou Y, Jin J. Outcome of adult T-lymphoblastic lymphoma depends on ALL-type chemotherapy, prognostic factors, and performance of allogeneic hematopoietic stem cell transplantation. Medicine (Baltimore) 2018; 97:e11374. [PMID: 29995776 PMCID: PMC6076131 DOI: 10.1097/md.0000000000011374] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
To study the prognostic factors of adult patients with T-lymphoblastic lymphoma (T-LBL) and to evaluate therapeutic effects of acute lymphoblastic leukemia (ALL)-type chemotherapy in combination with allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients who achieved overall response (OR) with first line ALL-type chemotherapy.This was a retrospective study of 59 adult patients with T-LBL treated with hyper-fractionated administration of cyclophosphamide, vincristine, doxorubicin and dexamethasone/methotrexate (hyper-CVAD/MA) chemotherapy alone or in combination with allo-HSCT between June 2008 and October 2015. Complete response (CR) and OR rates were evaluated after the initial chemotherapy. Clinical characteristics and the risk factors associated with prognosis and overall survival (OS) were analyzed in all patients and the effects of allo-HSCT on OS were evaluated in patients who had achieved OR after initial chemotherapy.Forty-eight patients (81.4%) achieved OR by hyper-CVAD chemotherapy, among which, 22 patients (45.8%) further received allo-HSCT. The median follow-up was 31.5 months, ranging from 11 to 97 months. The 3-year OS and progression-free survival (PFS) were 45.7% and 45.0% for patients who achieved OR after chemotherapy and both 0 for patients who did not achieve OR (both P < .001). Three year OS and PFS were higher in patients who received chemotherapy + allo-HSCT than in patients who received chemotherapy alone (3-year OS: 72.8% vs 17.5%, P = .008; PFS: 65.1% vs 27.8%, P = 0.007). Shorter survival was independently associated with elevated lactic dehydrogenase (LDH), Ki-67≥75%, pleural effusion and no OR (all P < .05) in all patients. But shorter survival was only associated with elevated LDH level, leukocytosis (>10 G/L), and chemotherapy alone in patients who achieved OR (all P < .05).The mid-term outcomes of adult patients with T-LBL are associated with response to chemotherapy (in all patients) and performance of allo-HSCT (in patients who achieved OR). Allo-HSCT could be a feasible and effective consolidation therapy for adult T-LBL.
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Affiliation(s)
- Meiwei Hu
- Department of Hematology, the Second Affiliated Hospital of Zhejiang Chinese Medical University
| | - Huafeng Wang
- Department of Hematology, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, Zhejiang, China
| | - Lei Wang
- Department of Hematology, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, Zhejiang, China
| | - Min Yang
- Department of Hematology, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, Zhejiang, China
| | - Yinjun Lou
- Department of Hematology, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, Zhejiang, China
| | - Jie Jin
- Department of Hematology, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, Zhejiang, China
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Allogeneic hematopoietic stem cell transplantation should be in preference to conventional chemotherapy as post-remission treatment for adults with lymphoblastic lymphoma. Bone Marrow Transplant 2018; 53:1340-1344. [PMID: 29712994 PMCID: PMC6173686 DOI: 10.1038/s41409-018-0184-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 03/08/2018] [Accepted: 03/19/2018] [Indexed: 11/08/2022]
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Zhang X. [How I treat non-Hodgkin's lymphoma by autologous hematopoietic stem cell transplantation]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2018; 39:94-97. [PMID: 29562440 PMCID: PMC7342566 DOI: 10.3760/cma.j.issn.0253-2727.2018.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Indexed: 11/24/2022]
Affiliation(s)
- X Zhang
- Department of Hematology, Xinqiao Hospital, The Army Medical University, Chongqing 400037, China
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28
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Adult T-type lymphoblastic lymphoma: Treatment advances and prognostic indicators. Exp Hematol 2017; 51:7-16. [DOI: 10.1016/j.exphem.2017.04.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 03/24/2017] [Accepted: 04/03/2017] [Indexed: 12/19/2022]
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Cortelazzo S, Ferreri A, Hoelzer D, Ponzoni M. Lymphoblastic lymphoma. Crit Rev Oncol Hematol 2017; 113:304-317. [DOI: 10.1016/j.critrevonc.2017.03.020] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 03/12/2017] [Accepted: 03/15/2017] [Indexed: 12/15/2022] Open
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Jaime-Pérez J, Villarreal-Villarreal C, Alvarado-Bernal Y, Padilla-Medina J, Fernández L, Gómez-Almaguer D. Bone marrow architecture reconstitution after hematopoietic grafting: A cross-sectional study. MEDICINA UNIVERSITARIA 2017. [DOI: 10.1016/j.rmu.2017.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Makita S, Fuji S, Takano K, Tanaka T, Inoue Y, Ito R, Ito A, Hayashi Y, Tajima K, Okinaka K, Kurosawa S, Kim SW, Yamashita T, Tanosaki R, Tobinai K, Fukuda T. Clinical Outcomes after Allogeneic Stem Cell Transplantation for Adult Lymphoblastic Lymphoma. J Clin Exp Hematop 2017; 56:28-33. [PMID: 27334855 DOI: 10.3960/jslrt.56.28] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Lymphoblastic lymphoma (LBL) is a rare subtype of non-Hodgkin lymphoma. There are limited reports on allogeneic stem cell transplantation (allo-SCT) in patients with LBL. We retrospectively analyzed the clinical outcomes of 15 adult patients with LBL who received allo-SCT at our institution. The median age at allo-SCT was 29 years (range, 18-42). Disease status at the time of transplantation was complete remission (CR), partial remission (PR), and advanced disease in 4, 4, and 7 patients, respectively. The median follow-up duration of survivors was 25 months (range, 6-106). The probabilities of overall survival (OS) and progression-free survival (PFS) at 2 years after allo-SCT were 37% and 24%, respectively. The respective 2-year OS and PFS rates of the 8 patients with CR or PR at the time of transplantation were 57% and 45%, while those with advanced disease were 14% and 0%. In conclusion, the treatment outcomes of allo-SCT in patients with LBL were unsatisfactory. Although outcomes were promising in patients with CR or PR at the time of transplantation, they were dismal in patients with progressive disease. Further advances in chemotherapy, both induction and salvage therapies, are needed to improve the clinical outcomes of patients with LBL.
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Affiliation(s)
- Shinichi Makita
- Departments of Hematopoietic Stem Cell Transplantation National Cancer Center Hospital
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Michaux K, Bergeron C, Gandemer V, Mechinaud F, Uyttebroeck A, Bertrand Y. Relapsed or Refractory Lymphoblastic Lymphoma in Children: Results and Analysis of 23 Patients in the EORTC 58951 and the LMT96 Protocols. Pediatr Blood Cancer 2016; 63:1214-21. [PMID: 27037853 DOI: 10.1002/pbc.25990] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 02/25/2016] [Accepted: 03/06/2016] [Indexed: 12/23/2022]
Abstract
BACKGROUND The treatment of children with T-cell lymphoblastic lymphoma (T-LBL) and precursor B-cell lymphoblastic lymphoma (pB-LBL) has improved during the last decades. However, patients with relapsed or refractory lymphomas still have a poor prognosis. METHODS We report the characteristics and evolution of T-LBL and pB-LBL relapses in two multicenter prospective studies (LMT 96, European Organization for Research and Treatment of Cancer 58951). RESULTS From 1997 to 2008, 194 patients were included in these studies (157 T-LBL; 37 pB-LBL); among them, 23 patients underwent relapse or progression (18 T-LBL and 5 pB-LBL). The median age was 7.7 years (range 1.4-16.3). The survival rate at 8 years was 8.7% (21 deaths). The median time from diagnosis to relapse was 9 months [1-69] and 11 months [1-45] for T-LBL and pB-LBL, respectively. Twenty-two patients received a second-line treatment but remission was achieved in only seven patients. In 10 patients, intensification with hematopoietic stem cell transplantation (HSCT) was performed and four of them had a second relapse. Two patients still alive had T-LBL, experienced relapses 15 and 69 months after diagnosis, and received HSCT. Relapse during the intensive phase and second-line treatment without HSCT were identified as risk factors for bad prognosis (P = 0.01). CONCLUSIONS The results of second-line treatment, including intensive chemotherapy and HSCT, show that salvage treatment is still disappointing in controlling refractory forms. Early identification of patients at high risk of relapse is mandatory, allowing earlier intensification. Valid prognostic parameters, such as biological markers, are needed. International cooperation is warranted to collect more data on these rare diagnoses.
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Affiliation(s)
- Katell Michaux
- Pediatric Hematology/Oncology Department (IHOP), Hospices Civils de Lyon and Centre Léon Bérard, Lyon, France
| | - Christophe Bergeron
- Pediatric Hematology/Oncology Department (IHOP), Hospices Civils de Lyon and Centre Léon Bérard, Lyon, France
| | - Virginie Gandemer
- Pediatric Hematology Department, University Hospital, Rennes, France
| | - Françoise Mechinaud
- Pediatric Hematology/Oncology Department, University Hospital, Nantes, France
| | - Anne Uyttebroeck
- Pediatric Hematology/Oncology Department, University Hospital Gasthuisberg, Leuven, Belgium
| | - Yves Bertrand
- Pediatric Hematology/Oncology Department (IHOP), Hospices Civils de Lyon and Centre Léon Bérard, Lyon, France.,Pediatric Hematology Department, University Hospital, Rennes, France.,Pediatric Hematology/Oncology Department, University Hospital, Nantes, France.,Pediatric Hematology/Oncology Department, University Hospital Gasthuisberg, Leuven, Belgium.,Claude Bernard Lyon 1 University, Lyon, France
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Brammer JE, Khouri I, Marin D, Ledesma C, Rondon G, Ciurea SO, Nieto Y, Champlin RE, Hosing C, Kebriaei P. Stem cell transplantation outcomes in lymphoblastic lymphoma. Leuk Lymphoma 2016; 58:366-371. [DOI: 10.1080/10428194.2016.1193860] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Alderuccio JP, Amarapurkar P, Chapman JR, Vega F, Lossos IS. Characteristics and outcomes of lymphoblastic lymphoma - the University of Miami experience. Leuk Lymphoma 2016; 58:195-198. [PMID: 27252116 DOI: 10.1080/10428194.2016.1177774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Juan Pablo Alderuccio
- a Department of Medicine, Division of Hematology-Oncology , Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine , Miami , FL , USA
| | - Pooja Amarapurkar
- b Department of Medicine, Division of Internal Medicine , Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine , Miami , FL , USA
| | - Jennifer R Chapman
- c Department of Pathology and Laboratory Medicine, Division of Hematopathology , Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine , Miami , FL , USA
| | - Francisco Vega
- a Department of Medicine, Division of Hematology-Oncology , Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine , Miami , FL , USA.,c Department of Pathology and Laboratory Medicine, Division of Hematopathology , Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine , Miami , FL , USA
| | - Izidore S Lossos
- a Department of Medicine, Division of Hematology-Oncology , Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine , Miami , FL , USA.,d Department of Molecular and Cellular Pharmacology , Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine , Miami , FL , USA
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35
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Cairo MS, Pinkerton R. Childhood, adolescent and young adult non-Hodgkin lymphoma: state of the science. Br J Haematol 2016; 173:507-30. [DOI: 10.1111/bjh.14035] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Mitchell S. Cairo
- Department of Pediatrics, Medicine, Pathology, Microbiology & Immunology and Cell Biology & Anatomy; New York Medical College; Valhalla NY USA
| | - Ross Pinkerton
- Department of Oncology; Children's Health Queensland; Brisbane Australia
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36
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Hochberg J, El-Mallawany NK, Abla O. Adolescent and young adult non-Hodgkin lymphoma. Br J Haematol 2016; 173:637-50. [PMID: 27071675 DOI: 10.1111/bjh.14074] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Non-Hodgkin lymphoma (NHL) is a heterogeneous group of lymphoid malignancies accounting for a significant portion of cancers occurring in children, adolescents and young adults with an increasing incidence with age. The adolescent and young adult (AYA) population presents a specific set of characteristics and challenges. The most common diseases occurring in adolescents and young adults include Burkitt lymphoma, lymphoblastic lymphoma, diffuse large B-cell lymphoma, anaplastic large cell lymphoma and primary mediastinal B-cell lymphoma. There is also a higher incidence of primary central nervous system lymphoma in AYA patients. Cure rates largely depend on risk-stratification, and are generally superior to outcomes in comparison to older adult data but less than in younger children. Here, we review the unique clinical and biological characteristics of NHL occurring in the AYA population with a focus on how to achieve similar curative outcomes in AYA that have been established in younger cohorts.
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Affiliation(s)
- Jessica Hochberg
- Department of Pediatrics, New York Medical College, Valhalla, NY, USA
| | | | - Oussama Abla
- Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada
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37
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Lepretre S, Touzart A, Vermeulin T, Picquenot JM, Tanguy-Schmidt A, Salles G, Lamy T, Béné MC, Raffoux E, Huguet F, Chevallier P, Bologna S, Bouabdallah R, Benichou J, Brière J, Moreau A, Tallon-Simon V, Seris S, Graux C, Asnafi V, Ifrah N, Macintyre E, Dombret H. Pediatric-Like Acute Lymphoblastic Leukemia Therapy in Adults With Lymphoblastic Lymphoma: The GRAALL-LYSA LL03 Study. J Clin Oncol 2016; 34:572-80. [DOI: 10.1200/jco.2015.61.5385] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Purpose This study evaluated the efficacy of pediatric-like acute lymphoblastic leukemia (ALL) therapy in adults with lymphoblastic lymphoma (LL). Patients and Methods This was a prospective phase II study in adults 18 to 59 years old with previously untreated LL. Patients were treated with an adapted pediatric-like ALL protocol, which included a corticosteroid prephase, a five-drug induction reinforced by sequential cyclophosphamide administration, dose-dense consolidation, late intensification, CNS prophylaxis, and a 2-year maintenance phase. Treatment response was assessed by computed tomography and optional positron emission tomography. Allogeneic hematopoietic stem cell transplant was offered to selected patients in first complete remission (CR) or unconfirmed CR. Results The study enrolled 148 patients (131 with T-lineage LL [T-LL] and 17 with B-lineage LL [B-LL]). A total of 119 patients with T-LL (90.8%) and 13 with B-LL (76.5%) reached CR/unconfirmed CR, including 26 with T-LL and two with B-LL who needed a second induction salvage course. Relapse occurred in 34 patients with T-LL and four with B-LL. In patients with T-LL, 3-year event-free survival was 63.3% (95% CI, 54.2% to 71.0%), disease-free survival was 72.4% (95% CI, 63.0% to 79.7%), and overall survival was 69.2% (95% CI, 60.0% to 76.7%). Multivariate analysis identified serum lactate dehydrogenase level and the NOTCH1/FBXW7/RAS/PTEN oncogene (a four-gene oncogenetic classifier) status but not positron emission tomography or hematopoietic stem cell transplant as independent prognostic factors for outcome in T-LL. Conclusion In adults with LL, an intensive pediatric-like ALL treatment protocol was associated with a good response rate and outcome. In patients with T-LL, the four-gene oncogenetic classifier and lactate dehydrogenase level were independent prognostic indicators.
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Affiliation(s)
- Stéphane Lepretre
- Stéphane Lepretre, Valérie Tallon-Simon, and Stéphanie Seris, Institut National de la Santé et de la Recherche Médicale (INSERM) U918, University of Rouen, Centre de Lutte contre le Cancer de Haute-Normandie (CLCC) H. Becquerel; Thomas Vermeulin and Jacques Benichou, Centre Hospitalier Universitaire (CHU) Charles Nicolle and INSERM U657, University of Rouen; Jean-Michel Picquenot, CLCC H. Becquerel, Rouen; Aurore Touzart, Vahid Asnafi, and Elizabeth Macintyre, University Paris Descartes Sorbonne Cité,
| | - Aurore Touzart
- Stéphane Lepretre, Valérie Tallon-Simon, and Stéphanie Seris, Institut National de la Santé et de la Recherche Médicale (INSERM) U918, University of Rouen, Centre de Lutte contre le Cancer de Haute-Normandie (CLCC) H. Becquerel; Thomas Vermeulin and Jacques Benichou, Centre Hospitalier Universitaire (CHU) Charles Nicolle and INSERM U657, University of Rouen; Jean-Michel Picquenot, CLCC H. Becquerel, Rouen; Aurore Touzart, Vahid Asnafi, and Elizabeth Macintyre, University Paris Descartes Sorbonne Cité,
| | - Thomas Vermeulin
- Stéphane Lepretre, Valérie Tallon-Simon, and Stéphanie Seris, Institut National de la Santé et de la Recherche Médicale (INSERM) U918, University of Rouen, Centre de Lutte contre le Cancer de Haute-Normandie (CLCC) H. Becquerel; Thomas Vermeulin and Jacques Benichou, Centre Hospitalier Universitaire (CHU) Charles Nicolle and INSERM U657, University of Rouen; Jean-Michel Picquenot, CLCC H. Becquerel, Rouen; Aurore Touzart, Vahid Asnafi, and Elizabeth Macintyre, University Paris Descartes Sorbonne Cité,
| | - Jean-Michel Picquenot
- Stéphane Lepretre, Valérie Tallon-Simon, and Stéphanie Seris, Institut National de la Santé et de la Recherche Médicale (INSERM) U918, University of Rouen, Centre de Lutte contre le Cancer de Haute-Normandie (CLCC) H. Becquerel; Thomas Vermeulin and Jacques Benichou, Centre Hospitalier Universitaire (CHU) Charles Nicolle and INSERM U657, University of Rouen; Jean-Michel Picquenot, CLCC H. Becquerel, Rouen; Aurore Touzart, Vahid Asnafi, and Elizabeth Macintyre, University Paris Descartes Sorbonne Cité,
| | - Aline Tanguy-Schmidt
- Stéphane Lepretre, Valérie Tallon-Simon, and Stéphanie Seris, Institut National de la Santé et de la Recherche Médicale (INSERM) U918, University of Rouen, Centre de Lutte contre le Cancer de Haute-Normandie (CLCC) H. Becquerel; Thomas Vermeulin and Jacques Benichou, Centre Hospitalier Universitaire (CHU) Charles Nicolle and INSERM U657, University of Rouen; Jean-Michel Picquenot, CLCC H. Becquerel, Rouen; Aurore Touzart, Vahid Asnafi, and Elizabeth Macintyre, University Paris Descartes Sorbonne Cité,
| | - Gilles Salles
- Stéphane Lepretre, Valérie Tallon-Simon, and Stéphanie Seris, Institut National de la Santé et de la Recherche Médicale (INSERM) U918, University of Rouen, Centre de Lutte contre le Cancer de Haute-Normandie (CLCC) H. Becquerel; Thomas Vermeulin and Jacques Benichou, Centre Hospitalier Universitaire (CHU) Charles Nicolle and INSERM U657, University of Rouen; Jean-Michel Picquenot, CLCC H. Becquerel, Rouen; Aurore Touzart, Vahid Asnafi, and Elizabeth Macintyre, University Paris Descartes Sorbonne Cité,
| | - Thierry Lamy
- Stéphane Lepretre, Valérie Tallon-Simon, and Stéphanie Seris, Institut National de la Santé et de la Recherche Médicale (INSERM) U918, University of Rouen, Centre de Lutte contre le Cancer de Haute-Normandie (CLCC) H. Becquerel; Thomas Vermeulin and Jacques Benichou, Centre Hospitalier Universitaire (CHU) Charles Nicolle and INSERM U657, University of Rouen; Jean-Michel Picquenot, CLCC H. Becquerel, Rouen; Aurore Touzart, Vahid Asnafi, and Elizabeth Macintyre, University Paris Descartes Sorbonne Cité,
| | - Marie-Christine Béné
- Stéphane Lepretre, Valérie Tallon-Simon, and Stéphanie Seris, Institut National de la Santé et de la Recherche Médicale (INSERM) U918, University of Rouen, Centre de Lutte contre le Cancer de Haute-Normandie (CLCC) H. Becquerel; Thomas Vermeulin and Jacques Benichou, Centre Hospitalier Universitaire (CHU) Charles Nicolle and INSERM U657, University of Rouen; Jean-Michel Picquenot, CLCC H. Becquerel, Rouen; Aurore Touzart, Vahid Asnafi, and Elizabeth Macintyre, University Paris Descartes Sorbonne Cité,
| | - Emmanuel Raffoux
- Stéphane Lepretre, Valérie Tallon-Simon, and Stéphanie Seris, Institut National de la Santé et de la Recherche Médicale (INSERM) U918, University of Rouen, Centre de Lutte contre le Cancer de Haute-Normandie (CLCC) H. Becquerel; Thomas Vermeulin and Jacques Benichou, Centre Hospitalier Universitaire (CHU) Charles Nicolle and INSERM U657, University of Rouen; Jean-Michel Picquenot, CLCC H. Becquerel, Rouen; Aurore Touzart, Vahid Asnafi, and Elizabeth Macintyre, University Paris Descartes Sorbonne Cité,
| | - Françoise Huguet
- Stéphane Lepretre, Valérie Tallon-Simon, and Stéphanie Seris, Institut National de la Santé et de la Recherche Médicale (INSERM) U918, University of Rouen, Centre de Lutte contre le Cancer de Haute-Normandie (CLCC) H. Becquerel; Thomas Vermeulin and Jacques Benichou, Centre Hospitalier Universitaire (CHU) Charles Nicolle and INSERM U657, University of Rouen; Jean-Michel Picquenot, CLCC H. Becquerel, Rouen; Aurore Touzart, Vahid Asnafi, and Elizabeth Macintyre, University Paris Descartes Sorbonne Cité,
| | - Patrice Chevallier
- Stéphane Lepretre, Valérie Tallon-Simon, and Stéphanie Seris, Institut National de la Santé et de la Recherche Médicale (INSERM) U918, University of Rouen, Centre de Lutte contre le Cancer de Haute-Normandie (CLCC) H. Becquerel; Thomas Vermeulin and Jacques Benichou, Centre Hospitalier Universitaire (CHU) Charles Nicolle and INSERM U657, University of Rouen; Jean-Michel Picquenot, CLCC H. Becquerel, Rouen; Aurore Touzart, Vahid Asnafi, and Elizabeth Macintyre, University Paris Descartes Sorbonne Cité,
| | - Serge Bologna
- Stéphane Lepretre, Valérie Tallon-Simon, and Stéphanie Seris, Institut National de la Santé et de la Recherche Médicale (INSERM) U918, University of Rouen, Centre de Lutte contre le Cancer de Haute-Normandie (CLCC) H. Becquerel; Thomas Vermeulin and Jacques Benichou, Centre Hospitalier Universitaire (CHU) Charles Nicolle and INSERM U657, University of Rouen; Jean-Michel Picquenot, CLCC H. Becquerel, Rouen; Aurore Touzart, Vahid Asnafi, and Elizabeth Macintyre, University Paris Descartes Sorbonne Cité,
| | - Réda Bouabdallah
- Stéphane Lepretre, Valérie Tallon-Simon, and Stéphanie Seris, Institut National de la Santé et de la Recherche Médicale (INSERM) U918, University of Rouen, Centre de Lutte contre le Cancer de Haute-Normandie (CLCC) H. Becquerel; Thomas Vermeulin and Jacques Benichou, Centre Hospitalier Universitaire (CHU) Charles Nicolle and INSERM U657, University of Rouen; Jean-Michel Picquenot, CLCC H. Becquerel, Rouen; Aurore Touzart, Vahid Asnafi, and Elizabeth Macintyre, University Paris Descartes Sorbonne Cité,
| | - Jacques Benichou
- Stéphane Lepretre, Valérie Tallon-Simon, and Stéphanie Seris, Institut National de la Santé et de la Recherche Médicale (INSERM) U918, University of Rouen, Centre de Lutte contre le Cancer de Haute-Normandie (CLCC) H. Becquerel; Thomas Vermeulin and Jacques Benichou, Centre Hospitalier Universitaire (CHU) Charles Nicolle and INSERM U657, University of Rouen; Jean-Michel Picquenot, CLCC H. Becquerel, Rouen; Aurore Touzart, Vahid Asnafi, and Elizabeth Macintyre, University Paris Descartes Sorbonne Cité,
| | - Josette Brière
- Stéphane Lepretre, Valérie Tallon-Simon, and Stéphanie Seris, Institut National de la Santé et de la Recherche Médicale (INSERM) U918, University of Rouen, Centre de Lutte contre le Cancer de Haute-Normandie (CLCC) H. Becquerel; Thomas Vermeulin and Jacques Benichou, Centre Hospitalier Universitaire (CHU) Charles Nicolle and INSERM U657, University of Rouen; Jean-Michel Picquenot, CLCC H. Becquerel, Rouen; Aurore Touzart, Vahid Asnafi, and Elizabeth Macintyre, University Paris Descartes Sorbonne Cité,
| | - Anne Moreau
- Stéphane Lepretre, Valérie Tallon-Simon, and Stéphanie Seris, Institut National de la Santé et de la Recherche Médicale (INSERM) U918, University of Rouen, Centre de Lutte contre le Cancer de Haute-Normandie (CLCC) H. Becquerel; Thomas Vermeulin and Jacques Benichou, Centre Hospitalier Universitaire (CHU) Charles Nicolle and INSERM U657, University of Rouen; Jean-Michel Picquenot, CLCC H. Becquerel, Rouen; Aurore Touzart, Vahid Asnafi, and Elizabeth Macintyre, University Paris Descartes Sorbonne Cité,
| | - Valérie Tallon-Simon
- Stéphane Lepretre, Valérie Tallon-Simon, and Stéphanie Seris, Institut National de la Santé et de la Recherche Médicale (INSERM) U918, University of Rouen, Centre de Lutte contre le Cancer de Haute-Normandie (CLCC) H. Becquerel; Thomas Vermeulin and Jacques Benichou, Centre Hospitalier Universitaire (CHU) Charles Nicolle and INSERM U657, University of Rouen; Jean-Michel Picquenot, CLCC H. Becquerel, Rouen; Aurore Touzart, Vahid Asnafi, and Elizabeth Macintyre, University Paris Descartes Sorbonne Cité,
| | - Stéphanie Seris
- Stéphane Lepretre, Valérie Tallon-Simon, and Stéphanie Seris, Institut National de la Santé et de la Recherche Médicale (INSERM) U918, University of Rouen, Centre de Lutte contre le Cancer de Haute-Normandie (CLCC) H. Becquerel; Thomas Vermeulin and Jacques Benichou, Centre Hospitalier Universitaire (CHU) Charles Nicolle and INSERM U657, University of Rouen; Jean-Michel Picquenot, CLCC H. Becquerel, Rouen; Aurore Touzart, Vahid Asnafi, and Elizabeth Macintyre, University Paris Descartes Sorbonne Cité,
| | - Carlos Graux
- Stéphane Lepretre, Valérie Tallon-Simon, and Stéphanie Seris, Institut National de la Santé et de la Recherche Médicale (INSERM) U918, University of Rouen, Centre de Lutte contre le Cancer de Haute-Normandie (CLCC) H. Becquerel; Thomas Vermeulin and Jacques Benichou, Centre Hospitalier Universitaire (CHU) Charles Nicolle and INSERM U657, University of Rouen; Jean-Michel Picquenot, CLCC H. Becquerel, Rouen; Aurore Touzart, Vahid Asnafi, and Elizabeth Macintyre, University Paris Descartes Sorbonne Cité,
| | - Vahid Asnafi
- Stéphane Lepretre, Valérie Tallon-Simon, and Stéphanie Seris, Institut National de la Santé et de la Recherche Médicale (INSERM) U918, University of Rouen, Centre de Lutte contre le Cancer de Haute-Normandie (CLCC) H. Becquerel; Thomas Vermeulin and Jacques Benichou, Centre Hospitalier Universitaire (CHU) Charles Nicolle and INSERM U657, University of Rouen; Jean-Michel Picquenot, CLCC H. Becquerel, Rouen; Aurore Touzart, Vahid Asnafi, and Elizabeth Macintyre, University Paris Descartes Sorbonne Cité,
| | - Norbert Ifrah
- Stéphane Lepretre, Valérie Tallon-Simon, and Stéphanie Seris, Institut National de la Santé et de la Recherche Médicale (INSERM) U918, University of Rouen, Centre de Lutte contre le Cancer de Haute-Normandie (CLCC) H. Becquerel; Thomas Vermeulin and Jacques Benichou, Centre Hospitalier Universitaire (CHU) Charles Nicolle and INSERM U657, University of Rouen; Jean-Michel Picquenot, CLCC H. Becquerel, Rouen; Aurore Touzart, Vahid Asnafi, and Elizabeth Macintyre, University Paris Descartes Sorbonne Cité,
| | - Elizabeth Macintyre
- Stéphane Lepretre, Valérie Tallon-Simon, and Stéphanie Seris, Institut National de la Santé et de la Recherche Médicale (INSERM) U918, University of Rouen, Centre de Lutte contre le Cancer de Haute-Normandie (CLCC) H. Becquerel; Thomas Vermeulin and Jacques Benichou, Centre Hospitalier Universitaire (CHU) Charles Nicolle and INSERM U657, University of Rouen; Jean-Michel Picquenot, CLCC H. Becquerel, Rouen; Aurore Touzart, Vahid Asnafi, and Elizabeth Macintyre, University Paris Descartes Sorbonne Cité,
| | - Hervé Dombret
- Stéphane Lepretre, Valérie Tallon-Simon, and Stéphanie Seris, Institut National de la Santé et de la Recherche Médicale (INSERM) U918, University of Rouen, Centre de Lutte contre le Cancer de Haute-Normandie (CLCC) H. Becquerel; Thomas Vermeulin and Jacques Benichou, Centre Hospitalier Universitaire (CHU) Charles Nicolle and INSERM U657, University of Rouen; Jean-Michel Picquenot, CLCC H. Becquerel, Rouen; Aurore Touzart, Vahid Asnafi, and Elizabeth Macintyre, University Paris Descartes Sorbonne Cité,
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Bassan R, Maino E, Cortelazzo S. Lymphoblastic lymphoma: an updated review on biology, diagnosis, and treatment. Eur J Haematol 2016; 96:447-60. [DOI: 10.1111/ejh.12722] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2015] [Indexed: 12/21/2022]
Affiliation(s)
- Renato Bassan
- Unità Operativa Complessa di Ematologia; Ospedale dell'Angelo & Ospedale SS. Giovanni e Paolo; Mestre-Venezia Italy
| | - Elena Maino
- Unità Operativa Complessa di Ematologia; Ospedale dell'Angelo & Ospedale SS. Giovanni e Paolo; Mestre-Venezia Italy
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Pillon M, Aricò M, Mussolin L, Carraro E, Conter V, Sala A, Buffardi S, Garaventa A, D'Angelo P, Lo Nigro L, Santoro N, Piglione M, Lombardi A, Porta F, Cesaro S, Moleti ML, Casale F, Mura R, d'Amore ESG, Basso G, Rosolen A. Long-term results of the AIEOP LNH-97 protocol for childhood lymphoblastic lymphoma. Pediatr Blood Cancer 2015; 62:1388-94. [PMID: 25755200 DOI: 10.1002/pbc.25469] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 10/02/2014] [Indexed: 01/06/2023]
Abstract
BACKGROUND Treatment intensification was considered a suitable strategy to increase the cure rate of lymphoblastic lymphoma (LBL) in children. PROCEDURE The AIEOP LNH-97 trial was run between 1997 and 2007 for newly diagnosed LBL in patients aged less than 18 years. Treatment schedule was based on the previous, LSA2-L2 derived, AIEOP LNH-92 protocol. Modifications included: increased dose of upfront cyclophosphamide and methotrexate, use of l-Asparaginase during induction therapy, intensive block therapy for slow responders, and late intensification ("Reinduction") for patients with advanced stage disease. Total therapy duration was 12 months for stage I and II, and 24 months for stage III and IV. Central nervous system prophylaxis did not include cranial irradiation. RESULTS 114 eligible patients were enrolled, 84 males and 30 females; median age was 9 years. Complete remission was obtained in 98% of patients. After a median follow-up time of seven years, 29 patients failed due to progression of disease (n = 2), relapse (n = 25), or second malignancy (n = 2). The 7-year overall survival was 82% (standard error [SE] 4%) and the 7-year event-free survival was 74% (SE 4%). No subgroup showed significantly different event free survival. None of the patients died of front line chemotherapy-related toxicity. CONCLUSIONS Treatment intensification was associated with good outcome in children and adolescents with LBL, with limited toxicity. Prognosis after relapse was better for patients who underwent allogeneic hematopoietic stem cell transplantation. Measurements of biological markers and treatment response are necessary for achieving further improvement through more accurate identification and stratification of patients at risk of disease relapse.
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Affiliation(s)
- Marta Pillon
- Clinic of Pediatric Hemato-Oncology, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | | | - Lara Mussolin
- Istituto di Ricerca Pediatrica, Fondazione Citt, à, della Speranza, Padova, Italy
| | - Elisa Carraro
- Clinic of Pediatric Hemato-Oncology, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Valentino Conter
- Clinica Pediatrica, Università degli Studi di Milano-Bicocca, Azienda Ospedaliera San Gerardo, Monza, Italy
| | - Alessandra Sala
- Clinica Pediatrica, Università degli Studi di Milano-Bicocca, Azienda Ospedaliera San Gerardo, Monza, Italy
| | - Salvatore Buffardi
- Pediatric Oncology Department, Santobono-Pausilipon Hospital of Napoli, Napoli, Italy
| | - Alberto Garaventa
- Department of Hematology-Oncology, Istituto Giannina Gaslini, Genova, Italy
| | - Paolo D'Angelo
- Department of Oncology, Pediatric Hematology and Oncology Unit, A.R.N.A.S. Ospedali Civico Di Cristina e Benfratelli, Palermo, Italy
| | - Luca Lo Nigro
- Pediatric Hematology-Oncology, Policlinico di Catania, Catania, Italy
| | - Nicola Santoro
- Division of Paediatric Haematology-Oncology, Department of Pediatrics, Bari, Italy
| | - Matilde Piglione
- Division of Pediatric Onco-Hematology, Regina Margherita Children's Hospital, Torino, Italy
| | - Alessandra Lombardi
- Dipartimento di Onco-Ematologia Pediatrica, Ospedale Bambino Gesù, Roma, Italy
| | - Fulvio Porta
- Oncology-Haematology and BMT Unit, Ospedale dei Bambini, Spedali Civili, Brescia, Italy
| | - Simone Cesaro
- Pediatric Hematology-Oncology, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Maria L Moleti
- Hematology, Department of Cellular Biotechnologies and Hematology, Roma, Italy
| | - Fiorina Casale
- Pediatric Oncology Service,, Pediatric Department, Second University of Napoli, Napoli, Italy
| | - Rossella Mura
- Pediatric Hematology-Oncology, Ospedale Pediatrico Microcitemico, Cagliari, Italy
| | | | - Giuseppe Basso
- Clinic of Pediatric Hemato-Oncology, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Angelo Rosolen
- Clinic of Pediatric Hemato-Oncology, Department of Women's and Children's Health, University of Padova, Padova, Italy
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Anti-thymocyte globulin could improve the outcome of allogeneic hematopoietic stem cell transplantation in patients with highly aggressive T-cell tumors. Blood Cancer J 2015; 5:e332. [PMID: 26230956 PMCID: PMC4526780 DOI: 10.1038/bcj.2015.54] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Accepted: 06/12/2015] [Indexed: 12/05/2022] Open
Abstract
The early experiment result in our hospital showed that anti-thymocyte globulin (ATG) inhibited the proliferation of lymphoid tumor cells in the T-cell tumors. We used the ATG as the part of the conditioning regimen and to evaluate the long-term anti-leukemia effect, the safety and complication in the patients with highly aggressive T-cell lymphomas. Twenty-three patients were enrolled into this study. At the time of transplant, six patients reached first or subsequent complete response, three patients had a partial remission and 14 patients had relapsed or primary refractory disease. The conditioning regimen consisted of ATG, total body irradiation, toposide and cyclophosphamide. The complete remission rate after transplant was 95.7%. At a median follow-up time of 25 months, 16 (69.6%) patients are alive and free from diseases, including nine patients in refractory and progressive disease. Seven patients died after transplant, five from relapse and two from treatment-related complications. The incidence of grades II–IV acute graft-vs-host disease (GvHD) was 39.1%. The maximum cumulative incidence of chronic GvHD was 30%. The most frequent and severe conditioning-related toxicities observed in 8 out of 23 patients were grades III/IV infections during cytopenia. Thus, ATG-based conditioning is a feasible and effective alternative for patients with highly aggressive T-cell tumors.
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Shi Y, Zhou S, He X, Han X, Wu S, Pan F, Liu P, Liu Y, Lei Y, Zhang H, Yang J, Qin Y, Zhang C, Yang S, Zhao L, Luo K, Wu G, Sun Y, Shi Y. Autologous hematopoietic stem cell transplantation in chemotherapy-sensitive lymphoblastic lymphoma: treatment outcome and prognostic factor analysis. Chin J Cancer Res 2015; 27:66-73. [PMID: 25717228 DOI: 10.3978/j.issn.1000-9604.2015.02.04] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 01/23/2015] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The study evaluated the effectiveness of autologous hematopoietic stem cell transplantation (AHSCT) in the treatment of lymphoblastic lymphoma (LL). METHODS We retrospectively analyzed the data from 41 patients with chemotherapy-sensitive LL who underwent hematopoietic stem cell transplantation (HSCT) from December 1989 to December 2009 in a single institution. RESULTS HSCT was conducted as first-line consolidation therapy and salvage therapy in 36 and 5 patients, respectively. The median follow-up was 97.1 months (range, 24.6-173.1 months). The 5-year overall survival (OS) and event-free survival (EFS) rate were 64% and 47% for the initially treated patients, respectively, and were both 20% for the relapsed ones. Bone marrow (BM) involvement and chemotherapy cycles prior to transplantation were identified as significant prognostic factors for EFS in multivariate analysis. CONCLUSIONS These results confirm that AHSCT is a reasonable option for chemotherapy-sensitive LL patients in first complete remission (CR1).
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Affiliation(s)
- Youwu Shi
- 1 Department of Medical Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China ; 2 National Center for Anticancer Drugs Clinical Study, Beijing 100021, China ; 3 Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China ; 4 Department of Radiation Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Shengyu Zhou
- 1 Department of Medical Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China ; 2 National Center for Anticancer Drugs Clinical Study, Beijing 100021, China ; 3 Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China ; 4 Department of Radiation Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Xiaohui He
- 1 Department of Medical Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China ; 2 National Center for Anticancer Drugs Clinical Study, Beijing 100021, China ; 3 Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China ; 4 Department of Radiation Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Xiaohong Han
- 1 Department of Medical Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China ; 2 National Center for Anticancer Drugs Clinical Study, Beijing 100021, China ; 3 Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China ; 4 Department of Radiation Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Shikai Wu
- 1 Department of Medical Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China ; 2 National Center for Anticancer Drugs Clinical Study, Beijing 100021, China ; 3 Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China ; 4 Department of Radiation Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Feng Pan
- 1 Department of Medical Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China ; 2 National Center for Anticancer Drugs Clinical Study, Beijing 100021, China ; 3 Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China ; 4 Department of Radiation Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Peng Liu
- 1 Department of Medical Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China ; 2 National Center for Anticancer Drugs Clinical Study, Beijing 100021, China ; 3 Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China ; 4 Department of Radiation Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Yinyu Liu
- 1 Department of Medical Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China ; 2 National Center for Anticancer Drugs Clinical Study, Beijing 100021, China ; 3 Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China ; 4 Department of Radiation Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Yingheng Lei
- 1 Department of Medical Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China ; 2 National Center for Anticancer Drugs Clinical Study, Beijing 100021, China ; 3 Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China ; 4 Department of Radiation Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Hongzhi Zhang
- 1 Department of Medical Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China ; 2 National Center for Anticancer Drugs Clinical Study, Beijing 100021, China ; 3 Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China ; 4 Department of Radiation Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Jianliang Yang
- 1 Department of Medical Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China ; 2 National Center for Anticancer Drugs Clinical Study, Beijing 100021, China ; 3 Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China ; 4 Department of Radiation Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Yan Qin
- 1 Department of Medical Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China ; 2 National Center for Anticancer Drugs Clinical Study, Beijing 100021, China ; 3 Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China ; 4 Department of Radiation Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Changgong Zhang
- 1 Department of Medical Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China ; 2 National Center for Anticancer Drugs Clinical Study, Beijing 100021, China ; 3 Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China ; 4 Department of Radiation Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Sheng Yang
- 1 Department of Medical Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China ; 2 National Center for Anticancer Drugs Clinical Study, Beijing 100021, China ; 3 Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China ; 4 Department of Radiation Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Liya Zhao
- 1 Department of Medical Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China ; 2 National Center for Anticancer Drugs Clinical Study, Beijing 100021, China ; 3 Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China ; 4 Department of Radiation Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Kehuan Luo
- 1 Department of Medical Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China ; 2 National Center for Anticancer Drugs Clinical Study, Beijing 100021, China ; 3 Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China ; 4 Department of Radiation Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Guanqing Wu
- 1 Department of Medical Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China ; 2 National Center for Anticancer Drugs Clinical Study, Beijing 100021, China ; 3 Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China ; 4 Department of Radiation Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Yan Sun
- 1 Department of Medical Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China ; 2 National Center for Anticancer Drugs Clinical Study, Beijing 100021, China ; 3 Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China ; 4 Department of Radiation Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Yuankai Shi
- 1 Department of Medical Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China ; 2 National Center for Anticancer Drugs Clinical Study, Beijing 100021, China ; 3 Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China ; 4 Department of Radiation Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
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Multicenter analysis of treatment outcomes in adult patients with lymphoblastic lymphoma who received hyper-CVAD induction followed by hematopoietic stem cell transplantation. Ann Hematol 2014; 94:617-25. [PMID: 25465233 DOI: 10.1007/s00277-014-2258-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Accepted: 11/10/2014] [Indexed: 10/24/2022]
Abstract
The hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (hyper-CVAD) regimen has been widely used for lymphoblastic lymphoma (LBL) as a primary treatment. However, there is few data about its treatment outcome in Asian patients. Thus, we conducted this study to evaluate the efficacy of hyper-CVAD induction and stem cell transplantation (SCT) consolidation in LBL patients. The treatment responses of 49 patients treated with the hyper-CVAD regimen were retrospectively analyzed in 13 institutions. Given 24 patients who responded to hyper-CVAD underwent consolidation treatment with SCT, overall survival (OS) and progression-free survival (PFS) of patients who received SCT were compared with patients who did not. The overall response rate was 79 %: 73 % (36/49) complete responses, 6 % (3/49) partial responses, and 4 % (2/49) induction deaths. The major limitation for the delivery of the planned hyper-CVAD cycles was hematological toxicity. Among 39 responders, 24 patients underwent autologous (n = 16) and allogeneic SCT (n = 8) consolidation. Their 3-year OS and PFS rates were 76 and 78 %, respectively, and there was no difference in survival outcomes between autologous and allogeneic SCT. However, 15 patients without SCT consolidation showed poorer PFS even though they all achieved complete response. Thus, only seven patients maintained their response at the time of analysis. In conclusion, the hyper-CVAD regimen is effective for remission induction in LBL, and SCT consolidation after hyper-CVAD induction produced better clinical outcomes than did continuation of hyper-CVAD.
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Mamidi MK, Dutta S, Bhonde R, Das AK, Pal R. Allogeneic and autologous mode of stem cell transplantation in regenerative medicine: Which way to go? Med Hypotheses 2014; 83:787-91. [DOI: 10.1016/j.mehy.2014.10.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 10/14/2014] [Indexed: 01/08/2023]
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Virtue SM, Manne SL, Mee L, Bartell A, Sands S, Gajda TM, Darabos K. Psychological distress and psychiatric diagnoses among primary caregivers of children undergoing hematopoietic stem cell transplant: an examination of prevalence, correlates, and racial/ethnic differences. Gen Hosp Psychiatry 2014; 36:620-6. [PMID: 25246347 PMCID: PMC4329245 DOI: 10.1016/j.genhosppsych.2014.08.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 08/08/2014] [Accepted: 08/27/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aims of the study were to examine the prevalence of self-reported psychological distress, examine the prevalence of interview-rated psychiatric diagnoses, identify correlates of psychological distress and psychiatric diagnosis and examine racial/ethnic group differences on measures of psychological distress among primary caregivers of children preparing to undergo hematopoietic stem cell transplant (HSCT). METHODS Caregivers (N = 215) completed the Beck Anxiety Inventory, Beck Depression Inventory (BDI), Impact of Events Scale, and a psychiatric interview assessing major depressive disorder, generalized anxiety disorder and panic disorder. Regression analyses examined correlates of distress and psychiatric diagnosis. Comparisons were made between racial/ethnic groups. RESULTS Posttraumatic stress symptoms were reported by 54% of caregivers during the time preparing for the child's HSCT. Twenty-seven percent of caregivers met diagnostic criteria for at least one of the psychiatric diagnoses during this time. Few factors were associated with distress or psychiatric diagnosis, except the child scheduled for allogeneic transplant, being married and prior psychological/psychiatric care. Sociodemographic factors accounted for racial/ethnic group differences, except that Hispanic/Latino caregivers reported higher BDI scores than non-Hispanic white caregivers. CONCLUSION Caregivers may be at greater risk of posttraumatic stress symptoms than anxiety or depression. Prior psychological/psychiatric treatment is a risk factor for greater psychological distress and psychiatric diagnosis during this time. Racial differences are mostly due to sociodemographic factors.
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MESH Headings
- Adolescent
- Adult
- Black or African American/psychology
- Black or African American/statistics & numerical data
- Anxiety Disorders/epidemiology
- Anxiety Disorders/ethnology
- Anxiety Disorders/psychology
- Caregivers/psychology
- Caregivers/statistics & numerical data
- Child
- Child, Preschool
- Depressive Disorder, Major/epidemiology
- Depressive Disorder, Major/ethnology
- Depressive Disorder, Major/psychology
- Female
- Hematopoietic Stem Cell Transplantation
- Hispanic or Latino/psychology
- Hispanic or Latino/statistics & numerical data
- Humans
- Infant
- Infant, Newborn
- Male
- Middle Aged
- Panic Disorder/epidemiology
- Panic Disorder/ethnology
- Panic Disorder/psychology
- Parents/psychology
- Prevalence
- Stress Disorders, Post-Traumatic/epidemiology
- Stress Disorders, Post-Traumatic/ethnology
- Stress Disorders, Post-Traumatic/psychology
- Stress, Psychological/epidemiology
- Stress, Psychological/ethnology
- Stress, Psychological/psychology
- White People/psychology
- White People/statistics & numerical data
- Young Adult
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Affiliation(s)
| | - Sharon L Manne
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Laura Mee
- Emory University School of Medicine, Atlanta, GA, USA
| | | | - Stephen Sands
- Columbia University Medical Center, New York, NY, USA
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Kato H, Kawase T, Kako S, Mizuta S, Kurokawa M, Mori T, Ohashi K, Iwato K, Miyamura K, Hidaka M, Sakamaki H, Suzuki R, Morishima Y, Tanaka J. Analysis of outcomes following autologous stem cell transplantation in adult patients with Philadelphia chromosome-negative acute lymphoblastic leukemia during first complete remission. Haematologica 2014; 99:e228-30. [PMID: 25015939 DOI: 10.3324/haematol.2014.108712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Harumi Kato
- Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
| | - Takakazu Kawase
- Program in Immunology, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Shinichi Kako
- Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan
| | - Shuichi Mizuta
- Department of Hematology, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Mineo Kurokawa
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Takehiko Mori
- Division of Hematology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuteru Ohashi
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Japan
| | - Koji Iwato
- Internal Medicine, Hiroshima Red Cross and Atomic-Bomb Survivals Hospital, Japan
| | - Koichi Miyamura
- Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Aichi, Japan
| | - Michihiro Hidaka
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Hisashi Sakamaki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Japan
| | - Ritsuro Suzuki
- Department of HSCT Data Management and Biostatistics, Nagoya University School of Medicine, Nagoya, Aichi, Japan
| | - Yasuo Morishima
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Aichi, Japan
| | - Junji Tanaka
- Department of Hematology, Tokyo Women's Medical University, Tokyo, Japan
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Ellin F, Jerkeman M, Hagberg H, Relander T. Treatment outcome in T-cell lymphoblastic lymphoma in adults - a population-based study from the Swedish Lymphoma Registry. Acta Oncol 2014; 53:927-34. [PMID: 24913153 DOI: 10.3109/0284186x.2014.889850] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND T-cell lymphoblastic lymphoma (T-LBL) is a rare neoplasm of precursor lymphoblast origin, for which there is no standard treatment for adults. Results of current treatment strategies in selected populations do exist but are largely unreported for unselected series. Here, we aimed to investigate treatment outcome in a population-based cohort. MATERIAL AND METHODS Patients were identified through the Swedish Lymphoma Registry and data was retrospectively collected for all adult (≥ 18 years) Swedish T-LBL patients diagnosed during 2000-2009. RESULTS A total of 39 patients with median age 40 years (range 18-78) were identified with females being significantly older than males (median age 66 vs. 37, p = 0.027). The five-year overall survival for all patients was 42%. Female gender was associated with shorter survival also when adjusted for treatment strategy and age [hazard ratio (HR) 4.29; p = 0.002]. Thirty patients received intensive chemotherapy, otherwise used for treatment of acute lymphoblastic leukemia (ALL), which resulted in an overall response rate of 97% and a five-year progression-free survival (PFS) of 49%. In this group only CNS involvement at diagnosis predicted shorter PFS (HR 13.3; p = 0.03). Among patients treated with hyper-CVAD the addition of mediastinal irradiation resulted in prolonged time to progression compared to patients receiving only chemotherapy (p = 0.047). The major reason for treatment failure was relapse and in this series 18-fluoro-deoxyglucose positron emission tomography (PET) did not predict this risk. CONCLUSION This population-based study indicates that all fit T-LBL patients should be considered for intensive treatment. Our results also suggest a beneficial effect of mediastinal irradiation in combination with hyper-CVAD treatment. Relapsing patients have a dismal outcome irrespective of salvage treatment.
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Affiliation(s)
- Fredrik Ellin
- Department of Internal Medicine, Kalmar County Hospital , Kalmar , Sweden
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Sequential myeloablative autologous stem cell transplantation and reduced intensity allogeneic hematopoietic cell transplantation is safe and feasible in children, adolescents and young adults with poor-risk refractory or recurrent Hodgkin and non-Hodgkin lymphoma. Leukemia 2014; 29:448-55. [PMID: 24938649 DOI: 10.1038/leu.2014.194] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 05/23/2014] [Accepted: 06/02/2014] [Indexed: 12/28/2022]
Abstract
The outcome of children, adolescents and young adults (CAYA) with poor-risk recurrent/refractory lymphoma is dismal (⩽30%). To overcome this poor prognosis, we designed an approach to maximize an allogeneic graft vs lymphoma effect in the setting of low disease burden. We conducted a multi-center prospective study of myeloablative conditioning (MAC) and autologous stem cell transplantation (AutoSCT), followed by a reduced intensity conditioning (RIC) and allogeneic hematopoietic cell transplantation (AlloHCT) in CAYA, with poor-risk refractory or recurrent lymphoma. Conditioning for MAC AutoSCT consisted of carmustine/etoposide/cyclophosphamide, RIC consisted of busulfan/fludarabine. Thirty patients, 16 Hodgkin lymphoma (HL) and 14 non-Hodgkin lymphoma (NHL), with a median age of 16 years and median follow-up of 5years, were enrolled. Twenty-three patients completed both MAC AutoSCT and RIC AlloHCT. Allogeneic donor sources included unrelated cord blood (n=9), unrelated donor (n=8) and matched siblings (n=6). The incidence of transplant-related mortality following RIC AlloHCT was only 12%. In patients with HL and NHL, 10 year EFS was 59.8% and 70% (P=0.613), respectively. In summary, this approach is safe, and long-term EFS with this approach is encouraging considering the poor-risk patient characteristics and the use of unrelated donors for RIC AlloHCT in the majority of cases.
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Assessing the Outcomes of a Supervised Exercise Intervention Following Recent Allogeneic Bone Marrow Transplantation: A Case Report. REHABILITATION ONCOLOGY 2014. [DOI: 10.1097/01893697-201432020-00003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Giulino-Roth L, Ricafort R, Kernan NA, Small TN, Trippett TM, Steinherz PG, Prockop SE, Scaradavou A, Chiu M, O'Reilly RJ, Boulad F. Ten-year follow-up of pediatric patients with non-Hodgkin lymphoma treated with allogeneic or autologous stem cell transplantation. Pediatr Blood Cancer 2013; 60:2018-24. [PMID: 24038967 DOI: 10.1002/pbc.24722] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Accepted: 07/12/2013] [Indexed: 11/07/2022]
Abstract
BACKGROUND Autologous or allogeneic hematopoietic stem cell transplant (SCT) is often considered in patients with relapsed or refractory non-Hodgkin lymphoma (NHL) but there are limited data on the use of SCT for the treatment of NHL in the pediatric setting. PROCEDURE To evaluate the role of SCT for children with NHL, we reviewed 36 consecutive pediatric patients with NHL who underwent an allogeneic (n = 21) or autologous (n = 15) SCT at our institution between 1982 and 2004. Pathologic classification included: lymphoblastic lymphoma (n = 12), Burkitt lymphoma (BL) (n = 5), diffuse large B-cell lymphoma (n = 4), anaplastic large cell lymphoma (ALCL) (n = 13), peripheral T cell lymphoma (n = 1), and undifferentiated NHL (n = 1). Donor source for allogeneic-SCT recipients was an HLA-matched related donor (n = 15), a matched unrelated donor (n = 4), or a mismatched donor (related n = 1; unrelated n = 1). Twenty-eight patients (78%) had chemotherapy responsive disease at the time of transplant (either CR or PR). RESULTS Overall survival (OS) and disease-free survival (DFS) were 55% and 53% with a median follow-up of 9.75 years. Outcomes were similar in patients receiving autologous and allogeneic-SCT (DFS 53% in both groups). Patients with ALCL had a DFS of 76.9%. In contrast, of five patients transplanted for BL, none survived. DFS among patients with chemotherapy sensitive disease was 61%, compared with 25% among patients with relapsed/refractory disease (P = 0.019). CONCLUSIONS Allogeneic and autologous SCT offer the prospect of durable, disease-free survival for a significant proportion of pediatric patients with relapsed or refractory NHL. Survival is superior among patients with chemotherapy sensitive disease.
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Affiliation(s)
- Lisa Giulino-Roth
- Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York; Department of Pediatrics, Weill Cornell Medical College, New York, New York
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Abstract
Adult lymphoblastic lymphoma (LBL) is an aggressive form of non-Hodgkin lymphoma occurring in predominantly adolescent and young adult men. Lymphoblastic lymphoma is rare, accounting for 1% to 2% of all non-Hodgkin lymphomas and is of T-cell phenotype in 90% of cases. Lymphoblastic lymphoma is morphologically indistinct from acute lymphoblastic leukemia (ALL). Both express their lineage-specific markers as well as terminal deoxynucleotidyl transferase. The differences are often made on clinical grounds. Lymphoblastic lymphoma is characterized by a predominantly nodal distribution of disease, often with a large mediastinal mass. Patients with less than 25% bone marrow involvement have typically been categorized as LBL rather than ALL, although this has not been applied consistently in the literature. Gene expression studies have identified differences in gene expression, with LBL expressing higher levels of genes associated with cytoskeleton, adhesion, angiogenesis, and chemotaxis than ALL. Although LBL and ALL can be distinct clinically, chemotherapy strategies are often very similar. Acute lymphoblastic leukemia regimens, which incorporate intensive multidrug induction, consolidation, delayed intensification, and maintenance, have been shown to be superior to standard lymphoma regimens. As central nervous system (CNS) relapse is common, CNS prophylaxis with high-dose chemotherapy and intrathecal therapy is also standard. The prophylactic use of CNS irradiation has declined with the introduction of chemotherapy regimens incorporating high doses of CNS-penetrating drugs such as cytarabine and methotrexate. The use of consolidative radiation to the mediastinum remains uncertain. High-dose chemotherapy followed by autologous or allogeneic transplantation as consolidation for patients in CR1 is controversial with modern intensive chemotherapy regimens, although transplantation has a proven role in the relapse setting.
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