Allogeneic Hematopoietic Cell Transplantation for Adult T Cell Acute Lymphoblastic Leukemia

Betty Ky Hamilton, Lisa Rybicki, Donna Abounader, Kehinde Adekola, Anjali Advani, Ibrahim Aldoss, Veronika Bachanova, Asad Bashey, Stacey Brown, Marcos DeLima, Steven Devine, Christopher R. Flowers, Siddharth Ganguly, Madan Jagasia, Vanessa E. Kennedy, Dennis Dong Hwan Kim, Joseph McGuirk, Vinod Pullarkat, Rizwan Romee, Karamjeet SandhuMelody Smith, Masumi Ueda, Auro Viswabandya, Khoan Vu, Sarah Wall, Simon B. Zeichner, Miguel Angel Perales, Navneet S. Majhail

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Allogeneic hematopoietic cell transplantation (HCT) is recommended for patients with T cell acute lymphoblastic leukemia (T-ALL) in second or later complete remission (CR) and high-risk patients in first CR. Given its relative rarity, data on outcomes of HCT for T-ALL are limited. We conducted a multicenter retrospective cohort study using data from 208 adult patients who underwent HCT between 2000 and 2014 to describe outcomes of allogeneic HCT for T-ALL in the contemporary era. The median age at HCT was 37 years, and the majority of patients underwent HCT in CR, using total body irradiation (TBI)-based myeloablative conditioning regimens. One-quarter of the patients underwent alternative donor HCT using a mismatched, umbilical cord blood, or haploidentical donor. With a median follow up of 38 months, overall survival at 5 years was 34%. The corresponding cumulative incidence of non-relapse mortality and relapse was 26% and 41%, respectively. In multivariable analysis, factors significantly associated with overall survival were the use of TBI (HR, 0.57; P =.021), age >35 years (HR, 1.55; P =.025), and disease status at HCT (HR, 1.98; P =.005 for relapsed/refractory disease compared with CR). Relapse was the most common cause of death (58% of patients). Allogeneic HCT remains a potentially curative option in selected patients with adult T-ALL, although relapse is a major cause of treatment failure.

Original languageEnglish (US)
Pages (from-to)1117-1121
Number of pages5
JournalBiology of Blood and Marrow Transplantation
Volume23
Issue number7
DOIs
StatePublished - Jul 2017

Keywords

  • Acute lymphoblastic leukemia
  • Allogeneic
  • Hematopoietic cell transplantation
  • Relapse-free survival
  • Survival
  • T cell

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    Hamilton, B. K., Rybicki, L., Abounader, D., Adekola, K., Advani, A., Aldoss, I., Bachanova, V., Bashey, A., Brown, S., DeLima, M., Devine, S., Flowers, C. R., Ganguly, S., Jagasia, M., Kennedy, V. E., Kim, D. D. H., McGuirk, J., Pullarkat, V., Romee, R., ... Majhail, N. S. (2017). Allogeneic Hematopoietic Cell Transplantation for Adult T Cell Acute Lymphoblastic Leukemia. Biology of Blood and Marrow Transplantation, 23(7), 1117-1121. https://doi.org/10.1016/j.bbmt.2017.04.003