Allogeneic haematopoietic stem cell transplantation for adult T‐lymphoblastic lymphoma: A real‐world multicentre analysis in China

Abstract

SummaryIn this multicentre, real‐world study, we aimed to identify the clinical outcomes and safety of allogeneic haematopoietic stem cell transplantation (allo‐HSCT) in T‐lymphoblastic lymphoma (T‐LBL). A total of 130 Ann Arbor stage III or IV T‐LBL patients (>16 years) treated with allo‐HSCT across five transplant centres were enrolled. The 2‐year cumulative incidence of disease progression, the probabilities of progression‐free survival (PFS), overall survival (OS) and non‐relapse mortality (NRM) after allo‐HSCT were 21.0%, 69.8%, 79.5% and 9.2% respectively. Patients with central nervous system (CNS) involvement had a higher cumulative incidence of disease progression compared with those without CNS involvement (57.1% vs. 18.9%, HR 3.78, p = 0.014). Patients receiving allo‐HSCT in non‐remission (NR) had a poorer PFS compared with those receiving allo‐HSCT in complete remission (CR) or partial remission (49.2% vs. 72.7%, HR 2.21, p = 0.041). Particularly for patients with bone marrow involvement and achieving CR before allo‐HSCT, measurable residual disease (MRD) positivity before allo‐HSCT was associated with a poorer PFS compared with MRD negativity (62.7% vs. 86.8%, HR 1.94, p = 0.036). On multivariate analysis, CNS involvement at diagnosis and receiving allo‐HSCT in NR were associated with disease progression. Thus, our real‐world data suggested that allo‐HSCT appeared to be an effective therapy for adult T‐LBL patients with Ann Arbor stage III or IV disease.