Outcomes of T-lymphoblastic lymphoma treated with pediatric ALL-like protocol.
Background
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.
['Sengar|Manju|M|', 'Carr|Robert|R|', 'Jain|Hasmukh|H|', 'Chanana|Raajit|R|', 'Rangarajan|Venkatesh|V|', 'Sridhar|Epari|E|', 'Shet|Tanuja|T|', 'Menon|Hari|H|', 'Gujral|Sumeet|S|', 'Laskar|Siddhartha|S|']
D005260:Female D006801:Humans D008297:Male D054218:Precursor T-Cell Lymphoblastic Leukemia-Lymphoma D016896:Treatment Outcome D055815:Young Adult
outcomes T-LBL BFM-90 PET response