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Annals of Oncology Advance Access originally published online on December 8, 2006
Annals of Oncology 2007 18(3):535-540; doi:10.1093/annonc/mdl426
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© 2006 European Society for Medical Oncology

hematologic malignancies

Primary therapy for adults with T-cell lymphoblastic lymphoma with hematopoietic stem-cell transplantation results in favorable outcomes

KW Song*, MJ Barnett, RD Gascoyne, M Chhanabhai, DL Forrest, DE Hogge, JC Lavoie, SH Nantel, TJ Nevill, JD Shepherd, CA Smith, HJ Sutherland, CL Toze, NJ Voss and JM Connors

The Leukemia/Bone Marrow Transplant Program of British Columbia, The Vancouver Hospital and Health Science Center, Divisions of Medical Oncology and Pathology, British Columbia Cancer Agency and University of British Columbia, Vancouver, British Columbia, Canada

* Correspondence to: Dr K. W. Song, Division of Hematology, Department of Medicine, Vancouver General Hospital, Jim Pattison Pavilion Room 3300, 950 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 4E3. Tel: +1 604-875-4863; Fax: +1 604-875-4763; E-mail: ksong{at}bccancer.bc.ca

Background: Controversy exists regarding the role of high-dose therapy followed by stem-cell transplant (SCT) in the treatment of T-cell lymphoblastic lymphoma (T-LBL). We conducted an intention-to-treat analysis of the strategy of SCT as definitive treatment of T-LBL.

Patients and methods: From July 1987 to March 2005, 34 adults with T-LBL were diagnosed and treated in British Columbia. Treatment, before planned SCT, consisted of a non-Hodgkin's lymphoma (NHL)/acute lymphoblastic leukemia hybrid chemotherapy protocol (28 patients) or a standard NHL chemotherapy regimen (six patients).

Results: Median follow-up of the 23 surviving patients is 51 months (range 13–142 months). Twenty-nine proceeded to SCT (four allogeneic, 25 autologous). For all 34 patients, 4-year overall survival (OS) and event-free survival (EFS) are 72% and 68%, respectively. For patients proceeding to SCT, the 4-year OS and EFS are 79% and 73%, respectively. All patients who received allografts are alive without disease at 38–141 months since diagnosis. For patients who received autografts, the 4-year EFS is 69%. Bone marrow involvement was a significant prognostic factor predicting for a worse survival (P = 0.02).

Conclusion: A treatment strategy for adults with chemosensitive T-LBL that includes planned consolidation with SCT in first response produces favorable long-term outcome.

Key words: acute lymphoblastic leukemia, lymphoblastic lymphoma, stem-cell transplant, T-cell lymphoma

Received for publication August 14, 2006. Revision received October 14, 2006. Accepted for publication October 16, 2006.


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