Abstract

Abstract 4556

Objective:

To investigatethe clinical features and prognostic factors, compare the treatment efficiency of chemotherapy and hematopoietic stem celltransplantation (HSCT) in Chinese patients with lymphoblastic lymphoma (LBL).

Methods:

We retrospectively analyzed clinical features, outcomes and prognosis of fifty-two patients with LBL who underwent chemotherapy (n=31) or HSCT (n=21) from January 1998 to December 2010 in our hospital.

Results:
  1. The median age was 19.5years (12–75 years). There was a male predominance with a ratio of 2.7:1. At presentation, 76.9% were T-cell immunophenotype, 90.4% were Ann Arbor stage III/‡W, 71.2% had mediastinal tumor, 30.8% presented with bone marrow involvement, and 7.7% had central nervous system (CNS) disease.

  2. Of the 52 patients, the overall response rate (ORR) was 90.4% and complete remission (CR) rate was 75.0%. The ORR rates in patients treated with ALL-like regimens and those treated with NHL-like regimens were 94.7% and 78.6%(P=0.221), CR rates were 81.6% and 57.2%(P=0.149), respectively.

  3. With a median follow-up of 19 months, the overall survival (OS) for all patients was 41.5% at two years and 29.0% at five years, and progression-free survival (PFS) was 33.2% and 25.3%, respectively. The 5-year OS rate was53.6% for the HSCT group and 12.1% for the chemotherapy group (P=0.001).

  4. For transplanted patients, 5-year PFS rate for patients who were in CR1 or not in CR1 before transplantation were 65.5% and 33.3%, respectively (P=0.036).

  5. Multivariate analyses showed that immunophenotype, lactatedehydrogenase (LDH), response to induction therapy and transplantation were independent prognostic factors (P<0.05). T-cell immunophenotype, elevated LDH, disease status more advanced than CR and patients without HSCT were associated with inferior outcomes.

Conclusion:

LBL is more common in young men and most patients had advanced diease at diagnosis. Clinically, it often presents with mediastinal, bone marrow and CNS involvement. More intensive ALL-like regimens appear superior to NHL-like regimens. Compared with chemotherapy, HSCT may improve overall survival. The use of HSCT in CR1 produces a trend for improved PFS. T-cell immunophenotype, elevated LDH, disease status more advanced than CR and patients without HSCT are independently associated with inferior outcomes.

Disclosures:

No relevant conflicts of interest to declare.

Author notes

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Asterisk with author names denotes non-ASH members.