Allogeneic versus autologous hematopoietic stem cell transplantation for adult T-lymphoblastic lymphoma: A real-world multicenter analysis in China

Abstract

Both allogeneic hematopoietic stem cell transplantation (allo-HSCT) and autologous HSCT (ASCT) are important consolidation therapies for T-lymphoblastic lymphoma (T-LBL). In this multicenter, real-world study, we aimed to compare the clinical outcomes between ASCT and allo-HSCT in adult T-LBL patients. 163 Ann Arbor stage III or IV T-LBL patients (>16 years) who achieved complete or partial response after induction chemotherapies and received HSCT across 11 transplant centers were enrolled. Patients with >25 % BM involvement or 5 % lymphoma cells in the peripheral blood at diagnosis were excluded. Landmark analyses were performed to assess outcomes within 1.5 years and between 1.5 years and 3 years after transplantation. The 3-year cumulative incidence of disease progression and non-relapse mortality (NRM) was 24.3 % versus 40.3 % (P = 0.04) and 14.6 % versus 7.1 % (P = 0.29), respectively, for allo-HSCT and ASCT group. The 3-year probability of progression-free survival (PFS) and overall survival (OS) after transplantation was 60.5 % versus 52.6 % (P = 0.34) and 65.8 % versus 61.8 % (P = 0.65), respectively, for allo-HSCT and ASCT group. In landmark analysis, allo-HSCT group showed a superior PFS to ASCT group at 1.5-3 years follow-up (P = 0.02). In conclusion, this large-scale real-world study showed that adults T-LBL patients might benefit more from allo-HSCT than ASCT.

Keywords: Adult; Allogeneic hematopoietic stem cell transplantation; Autologous hematopoietic stem cell transplantation; T-lymphoblastic lymphoma.