Outcomes of adult patients with early T-cell precursor (ETP) acute lymphoblastic leukemia/lymphoma (ALL) and non-ETP T-ALL

• Published in: International journal of hematology Vol. 117; no. 5; pp. 738 - 747
• Main Authors: Onishi, Yasushi, Furukawa, Eijiro, Kamata, Mayumi, Fukatsu, Masahiko, Kameoka, Yoshihiro, Hatta, Shunsuke, Hamada, Hiroyuki, Oyake, Tatsuo, Kai, Tatsuyuki, Sukegawa, Masumi, Nakajima, Shinji, Yanagiya, Ryo, Yamaguchi, Kohei, Takahashi, Taro, Harazaki, Yoriko, Izumi, Toru, Murai, Kazunori, Ito, Shigeki, Ikezoe, Takayuki, Ishizawa, Kenichi, Takahashi, Naoto, Harigae, Hideo
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01.05.2023; Springer Nature B.V
• Subjects: Acute lymphoblastic leukemia; Chemotherapy; Hematology; Humans; Induction therapy; Leukemia; Lymphocytes T; Lymphoma; Male; Medical prognosis; Medicine; Medicine & Public Health; Multivariate analysis; Oncology; Original Article; Phenotypes; Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy; Precursor Cells, T-Lymphoid; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma - diagnosis; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma - drug therapy; Precursors; Prognosis; Remission; Remission (Medicine); Retrospective Studies; Survival; Early T-cell precursor acute lymphoblastic leukemia/lymphoma; Immunophenotype; Allogeneic stem cell transplantation; T-cell acute lymphoblastic leukemia/lymphoma; Cord blood transplantation
• ISSN: 0925-5710; 1865-3774
• DOI: 10.1007/s12185-023-03546-6

Early T-cell precursor (ETP) acute lymphoblastic leukemia/lymphoma (ALL) is generally considered to be a high-risk subtype. We retrospectively analyzed the clinical outcomes of adult patients diagnosed with ETP-ALL or other T-cell ALL (non-ETP T-ALL). The subjects were 82 patients (ETP-ALL: n  = 18, non-ETP T-ALL: n  = 64) for whom relevant immunophenotype data needed for classification were available. ETP-ALL patients were older (median age, 50.5 vs. 33.5 years, P  = 0.042) and had less mediastinal involvement (27.8 vs. 73.4%, P  < 0.001). The rate of complete remission (CR) with the first induction therapy was significantly lower in the ETP group (33.3 vs. 64.0%, P  = 0.03), but the CR rate within 2 cycles of chemotherapy did not differ significantly (61.1 vs. 76.6%, P  = 0.232). The 3-year overall survival (OS) rate was also similar in both groups (43.2 vs. 45.8%, P  = 0.992). The ETP phenotype had no impact on survival in the transplant group or the non-transplant group. A multivariate analysis identified the male sex as a poor prognostic factor (HR: 4.43, P  < 0.01), but not the immunophenotype of ETP. The prognosis for adult patients with ETP-ALL was comparable to that of non-ETP T-ALL patients. However, further studies aimed at improving the remission rate for ETP-ALL are needed.