Wang Yuewen, Liu Weiping, Gu Zhenyang, Chang Yu, Zhang Chunli, Cao Yang, Lu Haiyang, Liu Xiaodan, Lu Kang, Lu Jin, Wang Fengrong, Wang Luxiang, Yang Shenmiao, Jiang Chuanhe, Li Chuan, Zhang Mingzhi, Huang Xiaojun, Zhu Xiaoyu, Wu Xiaojin, Hu Xiaoxia, Mo Xiaodong, Liu Daihong
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing 100044, China.
Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing 100142, China.
Cancer Lett. 2025 Jul 1;621:217664. doi: 10.1016/j.canlet.2025.217664. Epub 2025 Mar 22.
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.
异基因造血干细胞移植（allo-HSCT）和自体造血干细胞移植（ASCT）都是T淋巴母细胞淋巴瘤（T-LBL）重要的巩固治疗方法。在这项多中心、真实世界研究中，我们旨在比较成人T-LBL患者接受ASCT和allo-HSCT后的临床结局。纳入了163例年龄>16岁、诱导化疗后达到完全或部分缓解且在11个移植中心接受HSCT的Ann Arbor III期或IV期T-LBL患者。诊断时骨髓受累>25%或外周血淋巴瘤细胞占5%的患者被排除。进行了标志性分析以评估移植后1.5年内以及1.5年至3年之间的结局。allo-HSCT组和ASCT组的3年疾病进展累积发生率和非复发死亡率（NRM）分别为24.3%对40.3%（P=0.04）和14.6%对7.1%（P=0.29）。allo-HSCT组和ASCT组移植后的3年无进展生存（PFS）概率和总生存（OS）概率分别为60.5%对52.6%（P=0.34）和65.8%对61.8%（P=0.65）。在标志性分析中，allo-HSCT组在1.5至3年随访时的PFS优于ASCT组（P=0.02）。总之，这项大规模真实世界研究表明，成人T-LBL患者接受allo-HSCT可能比接受ASCT获益更多。
