title: Impact of conditioning with TBI in adult patients with T-cell ALL who receive a myeloablative allogeneic stem cell transplantation: a report from the acute leukemia working party of EBMT.
abstract: Allogeneic hematopoietic stem cell transplantation (allo-SCT) is a therapeutic option for adult patients with T-cell ALL (T-ALL). Meanwhile, few allo-SCT data specific to adult T-ALL have been described thus far. Specifically, the optimal myeloablative conditioning regimen is unknown. In this retrospective study, 601 patients were included. Patients received allo-SCT in CR1, CR2, CR >2 or in advanced disease in 69%, 15%, 2% and 14% of cases, respectively. With an overall follow-up of 58 months, 523 patients received a TBI-based regimen, whereas 78 patients received a chemotherapy-based regimen including IV busulfan-cyclophosphamide (IV Bu-Cy) (n=46). Unlike patients aged ⩾35 years, patients aged <35 years who received a TBI-based regimen displayed an improved outcome compared with patients who received a chemotherapy-based regimen (5-year leukemia-free survival (LFS) of 50% for TBI versus 18% for chemo-only regimen or IV Bu-Cy regimens, P=10(-5) and 10(-4), respectively). In multivariate analysis, use of TBI was associated with an improved LFS (hazard ratio (HR)=0.55 (0.34-0.86), P=0.01) and overall survival (HR=0.54 (0.34-0.87), P=0.01) in patients aged <35 years. In conclusion, younger adult patients with T-ALL entitled to receive a myeloablative allo-SCT may benefit from TBI-based regimens.
authors.affiliation: Hématologie Clinique, Hôpital Pontchaillou, CHU Rennes, France.
authors.forename: X
authors.initials: X
authors.lastname: Cahu
authors.affiliation: Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France.|Université Pierre and Marie Curie, Paris, France.|INSERM, UMR_S 938, INSERM, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Labopin
authors.affiliation: Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland.
authors.forename: S
authors.initials: S
authors.lastname: Giebel
authors.affiliation: Adult Hematology/HSCT, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
authors.forename: M
authors.initials: M
authors.lastname: Aljurf
authors.affiliation: Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, Katowice, Poland.
authors.forename: S
authors.initials: S
authors.lastname: Kyrcz-Krzemien
authors.affiliation: Hematology-Transplantation, Hospital St Louis, APHP, Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Socié
authors.affiliation: Hannover Medical School, Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Eder
authors.affiliation: Institute of Hematology, Department of Hematology and Oncological Sciences 'L. and A. Seràgnoli,' University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Bonifazi
authors.affiliation: Klinik für Innere Medizin III, Universitätsklinikum Ulm, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Bunjes
authors.affiliation: Hématologie Clinique et Thérapie Cellulaire, Hôpital Haut Levêque, Pessac, France.
authors.forename: S
authors.initials: S
authors.lastname: Vigouroux
authors.affiliation: Hématologie Clinique, Hospices Civils de Lyon, Lyon, France.
authors.forename: M
authors.initials: M
authors.lastname: Michallet
authors.affiliation: Department of Medicine A/Hematology and Oncology, University of Muenster Muenster, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Stelljes
authors.affiliation: Department of Hematology and Bone Marrow Transplantation, Rambam MCH, Haifa, Israel.
authors.forename: T
authors.initials: T
authors.lastname: Zuckerman
authors.affiliation: Department of Medecine-Hematology, Oncology, University of Freiburg, Freiburg, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Finke
authors.affiliation: Hematology, University Hospital of Basel, Basel, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Passweg
authors.affiliation: Hématologie Clinique, Hôpital Claude Huriez, Lille, France.
authors.forename: I
authors.initials: I
authors.lastname: Yakoub-Agha
authors.affiliation: University Hospital Leipzig, Clinic for Hematology and Oncology, Leipzig, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Niederwieser
authors.affiliation: Department of Hematology, Gazi University Faculty of Medicine, Ankara, Turkey.
authors.forename: G
authors.initials: G
authors.lastname: Sucak
authors.affiliation: National University Hospital, Copenhagen, Denmark.
authors.forename: H
authors.initials: H
authors.lastname: Sengeløv
authors.affiliation: Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France.|Université Pierre and Marie Curie, Paris, France.|INSERM, UMR_S 938, INSERM, Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Polge
authors.affiliation: Hematology Division, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Nagler
authors.affiliation: Hematology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Esteve
authors.affiliation: Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France.|Université Pierre and Marie Curie, Paris, France.|INSERM, UMR_S 938, INSERM, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Mohty
mesh_terms: D000328:Adult; D002066:Busulfan / Q000008:administration & dosage*; D003520:Cyclophosphamide / Q000008:administration & dosage*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D054218:Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / Q000401:mortality / Q000628:therapy; D012042:Registries; D015996:Survival Rate; D019172:Transplantation Conditioning / Q000379:methods*; D014916:Whole-Body Irradiation
chemical_list: D003520:Cyclophosphamide; D002066:Busulfan