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Allogeneic Hematopoietic Cell Transplantation for Adult T Cell Acute Lymphoblastic Leukemia
Betty Ky Hamilton1, Lisa Rybicki1, Donna Abounader1
1Blood and Marrow Transplant Program, Cleveland Clinic, Cleveland, Ohio.
Summary
Allogeneic hematopoietic cell transplantation (HCT) offers a potentially curative option for adult T cell acute lymphoblastic leukemia (T-ALL). However, relapse remains a significant challenge, impacting overall survival rates in this rare leukemia.
Area of Science:
- Hematology
- Oncology
- Transplantation Medicine
Background:
- Allogeneic hematopoietic cell transplantation (HCT) is a key treatment for T cell acute lymphoblastic leukemia (T-ALL).
- Limited data exist on contemporary HCT outcomes for T-ALL due to its rarity.
Purpose of the Study:
- To describe outcomes of allogeneic HCT for adult T-ALL in the modern era.
- To identify factors influencing survival after HCT for T-ALL.
Main Methods:
- Multicenter retrospective cohort study of 208 adult T-ALL patients undergoing HCT (2000-2014).
- Analysis included patient demographics, disease status, conditioning regimens (TBI-based), donor types, and survival outcomes.
Main Results:
- Five-year overall survival was 34%, with a 26% non-relapse mortality and 41% relapse incidence.
- Factors associated with improved survival included TBI use and CR disease status; older age (>35) was linked to worse survival.
- Relapse was the primary cause of death (58%).
Conclusions:
- Allogeneic HCT is a potentially curative treatment for selected adult T-ALL patients.
- Relapse remains the major obstacle to treatment success, necessitating further research into improving relapse control.