TY - JOUR
T1 - Outcomes of T-lymphoblastic lymphoma treated with pediatric ALL-like protocol
AU - Sengar, Manju
AU - Carr, Robert
AU - Jain, Hasmukh
AU - Chanana, Raajit
AU - Rangarajan, Venkatesh
AU - Sridhar, Epari
AU - Shet, Tanuja
AU - Menon, Hari
AU - Gujral, Sumeet
AU - Laskar, Siddhartha
PY - 2020/7/1
Y1 - 2020/7/1
N2 - The management of T-lymphoblastic lymphoma (T-LBL) in adults poses uncertainties, including optimal chemotherapy regimen, need for radiotherapy, and the benefit of stem cell transplant. This retrospective case series investigated the efficacy of the pediatric BFM-90 regimen in adult patients and evaluated the role of early response assessment by positron emission tomography with computed tomography (PET-CT) in predicting outcomes. Methods: Patients aged 15 years or older with T-LBL diagnosed at Tata Memorial Hospital, Mumbai, India were given chemotherapy according to the European BFM-90 protocol (n = 38). The patients were evaluated for early response by interim PET-CT, post-induction and monitored for toxicity and long-term outcomes. Results: Thirty-eight consecutive patients (median age 23.5 years) were analyzed. After a median follow-up of 33.5 (1-77) months, following induction, 35 out of 38 patients (92.1%) had achieved complete response (CR) on PET-CT. Thirty (78.9%) patients treated according to BFM-90 were alive in first remission. Three-year event-free survival for those with CR on PET-CT was 78%, against no survivors for those who remained PET-positive. Conclusion: This study demonstrates the feasibility and efficacy of BFM-90 approach in adults with T-LBL. We found an early PET response to be highly predictive of outcome.
AB - The management of T-lymphoblastic lymphoma (T-LBL) in adults poses uncertainties, including optimal chemotherapy regimen, need for radiotherapy, and the benefit of stem cell transplant. This retrospective case series investigated the efficacy of the pediatric BFM-90 regimen in adult patients and evaluated the role of early response assessment by positron emission tomography with computed tomography (PET-CT) in predicting outcomes. Methods: Patients aged 15 years or older with T-LBL diagnosed at Tata Memorial Hospital, Mumbai, India were given chemotherapy according to the European BFM-90 protocol (n = 38). The patients were evaluated for early response by interim PET-CT, post-induction and monitored for toxicity and long-term outcomes. Results: Thirty-eight consecutive patients (median age 23.5 years) were analyzed. After a median follow-up of 33.5 (1-77) months, following induction, 35 out of 38 patients (92.1%) had achieved complete response (CR) on PET-CT. Thirty (78.9%) patients treated according to BFM-90 were alive in first remission. Three-year event-free survival for those with CR on PET-CT was 78%, against no survivors for those who remained PET-positive. Conclusion: This study demonstrates the feasibility and efficacy of BFM-90 approach in adults with T-LBL. We found an early PET response to be highly predictive of outcome.
KW - BFM-90
KW - outcomes
KW - PET response
KW - T-LBL
UR - http://www.scopus.com/inward/record.url?scp=85089606523&partnerID=8YFLogxK
U2 - 10.4103/ijc.IJC_616_18
DO - 10.4103/ijc.IJC_616_18
M3 - Article
C2 - 32594075
AN - SCOPUS:85089606523
SN - 0019-509X
VL - 57
SP - 262
EP - 266
JO - Indian Journal of Cancer
JF - Indian Journal of Cancer
IS - 3
ER -