A childhood chemotherapy protocol improves overall survival among adults with T-lymphoblastic lymphoma

Abstract

// Meng-yuan Zhu 1, 2, 4, * , Hua Wang 1, 2, 4, * , Chun-yu Huang 1, 3, 4, * , Zhong-jun Xia 1, 2, 4 , Xiao-qin Chen 1, 2, 4 , Qi-rong Geng 1, 2, 4 , Wei-da Wang 1, 2, 4 , Liang Wang 1, 2, 4 , Yue Lu 1, 2, 4 1 State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, 510060 Guangzhou, Guangdong, P.R. China 2 Department of Hematological Oncology, Sun Yat-Sen University Cancer Center, 510060 Guangzhou, Guangdong, P.R. China 3 Department of Endoscopy, Sun Yat-Sen University Cancer Center, 510060 Guangzhou, Guangdong, P.R. China 4 Collaborative Innovation Center of Cancer Medicine, Sun Yat-Sen University Cancer Center, 510060 Guangzhou, Guangdong, P.R. China * These authors are contributed equally to this work Correspondence to: Yue Lu, email: [e-mail] Hua Wang, email: [e-mail] Keywords: T-lymphoblastic lymphoma, treatment, adult, childhood, chemotherapy Received: December 25, 2015      Accepted: April 16, 2016      Published: May 02, 2016 ABSTRACT A broadly accepted standard treatment for adult T-lymphoblastic lymphoma (T-LBL) has not yet been defined. To address that issue, we retrospectively compared three chemotherapy regimens used to treat 110 adult patients with newly diagnosed T-LBL. These included two adult regimens (ECOG2993 and hyper-CVAD) and a childhood regimen (BFM-90). These intensive drug regimens are mainly used to treat childhood and adult acute lymphoblastic leukemia. They included induction, consolidation, and maintenance chemotherapy protocols and were administered over the course of 2 years. Seventy-five patients (80%) achieved a complete remission (CR). Within a median follow-up time of 31 months (range: 5–152 months), the 5-year overall survival (OS) and progression-free survival (PFS) rates were 47.7% (95% CI, 35.0–69.8%) and 45.7% (95% CI, 27.6–56.6%), respectively. Shorter survival was associated with age > 40 years, poor ECOG PS and bone marrow involvement. Elevated lactic dehydrogenase (LDH) level, Ann Arbor stage and International Prognostic Index (IPI) score had no prognostic value. The childhood chemotherapy regimen improved CR and the overall survival rate more than the adult regimen in patients aged < 40 years.