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Acute Leukemia

Impact of conditioning with TBI in adult patients with T-cell ALL who receive a myeloablative allogeneic stem cell transplantation: a report from the acute leukemia working party of EBMT

Bone Marrow Transplantation volume 51, pages 351–357 (2016)Cite this article

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Abstract

Allogeneic hematopoietic stem cell transplantation (allo-SCT) is a therapeutic option for adult patients with T-cell ALL (T-ALL). Meanwhile, few allo-SCT data specific to adult T-ALL have been described thus far. Specifically, the optimal myeloablative conditioning regimen is unknown. In this retrospective study, 601 patients were included. Patients received allo-SCT in CR1, CR2, CR >2 or in advanced disease in 69%, 15%, 2% and 14% of cases, respectively. With an overall follow-up of 58 months, 523 patients received a TBI-based regimen, whereas 78 patients received a chemotherapy-based regimen including IV busulfan–cyclophosphamide (IV Bu-Cy) (n=46). Unlike patients aged ⩾35 years, patients aged <35 years who received a TBI-based regimen displayed an improved outcome compared with patients who received a chemotherapy-based regimen (5-year leukemia-free survival (LFS) of 50% for TBI versus 18% for chemo-only regimen or IV Bu-Cy regimens, P=10−5 and 10−4, respectively). In multivariate analysis, use of TBI was associated with an improved LFS (hazard ratio (HR)=0.55 (0.34–0.86), P=0.01) and overall survival (HR=0.54 (0.34–0.87), P=0.01) in patients aged <35 years. In conclusion, younger adult patients with T-ALL entitled to receive a myeloablative allo-SCT may benefit from TBI-based regimens.

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Acknowledgements

We thank all EBMT participating centers (listed in Supplementary Data), especially physicians and data managers for providing data. We also thank Leila Moukhtari and Hervé Finel for excellent data management.

Author contributions

XC, JE, SG and MM designed the study, analyzed data and wrote the manuscript; ML performed statistical analysis and helped writing the manuscript; EP coordinated data collection and management; HS provided and analyzed data; MA, SK-K, GS, ME, FB, DB, SV, MM, MS, TZ, JF, JP, IY-A, DN, GS and AN provided data and commented on the manuscript. All authors approved submission of the manuscript for publication purposes.

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Authors and Affiliations

  1. Hématologie Clinique, Hôpital Pontchaillou, CHU, Rennes, France

    X Cahu

  2. Service d’Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France

    M Labopin, E Polge & M Mohty

  3. Université Pierre and Marie Curie, Paris, France

    M Labopin, E Polge & M Mohty

  4. INSERM, UMR_S 938, INSERM, Paris, France

    M Labopin, E Polge & M Mohty

  5. Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland

    S Giebel

  6. Adult Hematology/HSCT, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

    M Aljurf

  7. Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, Katowice, Poland

    S Kyrcz-Krzemien

  8. Hematology-Transplantation, Hospital St Louis, APHP, Paris, France

    G Socié

  9. Department of Hematology, Hannover Medical School, Hemostasis, Oncology and Stem Cell Transplantation, Hannover, Germany

    M Eder

  10. Department of Hematology and Oncological Sciences ‘L. and A. Seràgnoli,’ University of Bologna, Institute of Hematology, S. Orsola-Malpighi Hospital, Bologna, Italy

    F Bonifazi

  11. Klinik für Innere Medizin III, Universitätsklinikum, Ulm, Germany

    D Bunjes

  12. Hématologie Clinique et Thérapie Cellulaire, Hôpital Haut Levêque, Pessac, France

    S Vigouroux

  13. Hématologie Clinique, Hospices Civils de Lyon, Lyon, France

    M Michallet

  14. Department of Medicine A/Hematology and Oncology, University of Muenster, Muenster, Germany

    M Stelljes

  15. Department of Hematology and Bone Marrow Transplantation, Rambam MCH, Haifa, Israel

    T Zuckerman

  16. Department of Medecine–Hematology, Oncology, University of Freiburg, Freiburg, Germany

    J Finke

  17. Hematology, University Hospital of Basel, Basel, Switzerland

    J Passweg

  18. Hématologie Clinique, Hôpital Claude Huriez, Lille, France

    I Yakoub-Agha

  19. University Hospital Leipzig, Clinic for Hematology and Oncology, Leipzig, Germany

    D Niederwieser

  20. Department of Hematology, Gazi University Faculty of Medicine, Ankara, Turkey

    G Sucak

  21. National University Hospital, Copenhagen, Denmark

    H Sengeløv

  22. Hematology Division, Chaim Sheba Medical Center, Tel-Hashomer, Israel

    A Nagler

  23. Hematology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain

    J Esteve

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  1. X Cahu
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on behalf of the Acute Leukemia Working Party of EBMT

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Correspondence to M Mohty.

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The authors declare no conflict of interest.

Additional information

This work was presented in part at the ASH 2012 meeting as an oral presentation.

Supplementary Information accompanies this paper on Bone Marrow Transplantation website

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Cahu, X., Labopin, M., Giebel, S. et al. Impact of conditioning with TBI in adult patients with T-cell ALL who receive a myeloablative allogeneic stem cell transplantation: a report from the acute leukemia working party of EBMT. Bone Marrow Transplant 51, 351–357 (2016). https://doi.org/10.1038/bmt.2015.278

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