DOI: 10.1182/blood-2023-185966 ISSN: 0006-4971

A Retrospective Comparison of Allogenic and Autologous Hematopoietic Stem Cell Transplantation in Patients with T-Cell Lymphoblastic Lymphoma

Ying Zhu, Tao You, Sicheng Ai, Mao Jin, Mengya Cong, Depei Wu, Haiwen Huang
  • Cell Biology
  • Hematology
  • Immunology
  • Biochemistry

Background: T-cell lymphoblastic lymphoma (T-LBL) is a rare type of non-Hodgkin's lymphoma accounting for 1%~2% of non-Hodgkin's lymphoma. T-cell lymphoblastic lymphoma is typically found in children and young adults, frequently affecting the mediastinum and bone marrow. It has a poor prognosis and develops quickly. It is anticipated that hematopoietic stem cell transplantation will significantly enhance the prognosis. We conducted a retrospective single center analysis aiming to compare the survival outcomes of autologous and allogeneic hematopoietic stem cell transplantation in patients with T-cell lymphoblastic lymphoma.

Methods: From our center's database, we track down 92 individuals who underwent T-LBL transplantation between August 2011 and June 2022, including 77 individuals who got allogeneic hematopoietic stem cell transplants and 15 patients who underwent autologous hematopoietic stem cell transplants.

Results:For the baseline characteristics of patients,there were significant differences in IPNHLSS staging, bone marrow involvement, IPI score and pre transplant status between Auto-HSCT group and Allo HSCT group.Group allo-HSCT had a higher proportion of bone marrow involvement (57.1% vs. 26.7%,p=0.031), a higher proportion of IPNHLSS staging as IV (57.1% vs. 26.7%,p=0.001) and a lower proportion of CR1 pre transplantations (51.9% vs. 86.7%,p=0.080).

Figure 1 had shown the survival between auto-HSCT group and allo-HSCT group.Among the 15 patients who received auto-HSCT, 2 patients received allogeneic transplantation after relapse, 1 patient died after 3.1 months of survival after secondary transplantation, and 1 patient still survived after secondary transplantation.The 3-year OS rate of auto-HSCT group was 87.7%, while the 3-year OS rate of allo-HSCT group was 65.0%(P=0.086).The 3-year PFS rate of auto-HSCT group was 74.0%, while the 3-year PFS rate of allo-HSCT patients was 73.3%(P=0.95). The 3-year NRM rate of auto-HSCT group was 0%, while the 3-year NRM rate of allo-HSCT group was 9.9%(P=0.127). The 3-year CIR rate of auto-HSCT group was 21.0%, while the 3-year NRM rate of allo-HSCT group was 25.3%(P=0.514).

Conclusion: Hematopoietic stem cell transplantation can significantly improve the prognosis of patients with T-cell lymphoblastic lymphoma. In our study, patients with T-cell lymphoblastic lymphomareceiving autologous hematopoietic stem cell transplantation and those receiving allogeneic hematopoietic stem cell transplantation have distinct baseline data, hence their survival rates also differ.

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