Outcomes of T-lymphoblastic lymphoma treated with pediatric ALL-like protocol.


Journal

Indian journal of cancer
ISSN: 1998-4774
Titre abrégé: Indian J Cancer
Pays: India
ID NLM: 0112040

Informations de publication

Date de publication:
Historique:
pubmed: 1 7 2020
medline: 15 12 2020
entrez: 29 6 2020
Statut: ppublish

Résumé

The management of T-lymphoblastic lymphoma (T-LBL) in adults poses uncertainties, including optimal chemotherapy regimen, need for radiotherapy, and the benefit of stem cell transplant. This retrospective case series investigated the efficacy of the pediatric BFM-90 regimen in adult patients and evaluated the role of early response assessment by positron emission tomography with computed tomography (PET-CT) in predicting outcomes. Patients aged 15 years or older with T-LBL diagnosed at Tata Memorial Hospital, Mumbai, India were given chemotherapy according to the European BFM-90 protocol (n = 38). The patients were evaluated for early response by interim PET-CT, post-induction and monitored for toxicity and long-term outcomes. Thirty-eight consecutive patients (median age 23.5 years) were analyzed. After a median follow-up of 33.5 (1-77) months, following induction, 35 out of 38 patients (92.1%) had achieved complete response (CR) on PET-CT. Thirty (78.9%) patients treated according to BFM-90 were alive in first remission. Three-year event-free survival for those with CR on PET-CT was 78%, against no survivors for those who remained PET-positive. This study demonstrates the feasibility and efficacy of BFM-90 approach in adults with T-LBL. We found an early PET response to be highly predictive of outcome.

Sections du résumé

BACKGROUND BACKGROUND
The management of T-lymphoblastic lymphoma (T-LBL) in adults poses uncertainties, including optimal chemotherapy regimen, need for radiotherapy, and the benefit of stem cell transplant. This retrospective case series investigated the efficacy of the pediatric BFM-90 regimen in adult patients and evaluated the role of early response assessment by positron emission tomography with computed tomography (PET-CT) in predicting outcomes.
METHODS METHODS
Patients aged 15 years or older with T-LBL diagnosed at Tata Memorial Hospital, Mumbai, India were given chemotherapy according to the European BFM-90 protocol (n = 38). The patients were evaluated for early response by interim PET-CT, post-induction and monitored for toxicity and long-term outcomes.
RESULTS RESULTS
Thirty-eight consecutive patients (median age 23.5 years) were analyzed. After a median follow-up of 33.5 (1-77) months, following induction, 35 out of 38 patients (92.1%) had achieved complete response (CR) on PET-CT. Thirty (78.9%) patients treated according to BFM-90 were alive in first remission. Three-year event-free survival for those with CR on PET-CT was 78%, against no survivors for those who remained PET-positive.
CONCLUSION CONCLUSIONS
This study demonstrates the feasibility and efficacy of BFM-90 approach in adults with T-LBL. We found an early PET response to be highly predictive of outcome.

Identifiants

pubmed: 32594075
pii: 287381
doi: 10.4103/ijc.IJC_616_18
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

262-266

Déclaration de conflit d'intérêts

None

Auteurs

Manju Sengar (M)

Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India.

Robert Carr (R)

Department of Haematology, Guy's and St Thomas' Hospital, King's College, London, UK.

Hasmukh Jain (H)

Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India.

Raajit Chanana (R)

Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India.

Venkatesh Rangarajan (V)

Department of Nuclear Medicine, Tata Memorial Hospital, Mumbai, Maharashtra, India.

Epari Sridhar (E)

Department of Pathology, Tata Memorial Hospital, Mumbai, Maharashtra, India.

Tanuja Shet (T)

Department of Pathology, Tata Memorial Hospital, Mumbai, Maharashtra, India.

Hari Menon (H)

Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India.

Sumeet Gujral (S)

Department of Pathology, Tata Memorial Hospital, Mumbai, Maharashtra, India.

Siddhartha Laskar (S)

Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India.

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Classifications MeSH