Pediatric-like Leukemia Treatment May Be Effective for Lymphoblastic Lymphoma

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An intensive pediatric-like acute lymphoblastic leukemia (ALL) treatment protocol was associated with a good response rate.
An intensive pediatric-like acute lymphoblastic leukemia (ALL) treatment protocol was associated with a good response rate.

An intensive pediatric-like acute lymphoblastic leukemia (ALL) treatment protocol was associated with a good response rate and outcome in adults with lymphoblastic lymphoma, a new study published online ahead of print in the Journal of Clinical Oncology has shown.1

Lymphoblastic lymphoma is a type of non-Hodgkin lymphoma that typically affects children and teenagers. As lymphoblastic lymphoma and ALL are similar, the National Comprehensive Cancer Network (NCCN) guidelines for the treatment of patients with lymphoblastic lymphoma and patients with ALL are the same.

For the phase 2 study, researchers sought to evaluate the efficacy of a pediatric-like ALL protocol consisting of a corticosteroid prophase, a 5-drug induction with sequential cyclophosphamide administration, dose-dense consolidation, late intensification, central nervous system prophylaxis, and a 2-year maintenance phase, in adult patients with lymphoblastic lymphoma.

Researchers enrolled 148 patients aged 18 to 59 years with lymphoblastic lymphoma, of which 131 patients had T-lineage lymphoblastic lymphoma and 17 patients had B-lineage lymphoblastic lymphoma.

Results showed that 90.8% of those patients with T-lineage disease and 76.5% of those patients with B-lineage disease achieved complete remission or unconfirmed complete remission, including 26 patients and 13 patients, respectively, who required a second induction salvage course.

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Researchers found that in patients with T-lineage lymphoblastic lymphoma, the 3-year event-free survival was 63.3% (95% CI, 54.2 - 71.0), disease-free survival was 72.4% (95% CI, 63.0 - 79.7), and overall survival was 69.2% (95% CI, 60.0 - 76.7).

The study also demonstrated that a 4-gene oncogenetic classifier (NOTCH1/FBXW7/RAS/PTEN) and lactate dehydrogenase level were independent prognostic factors for outcome in patients with T-lineage disease.

Reference

  1. Leprete S, Touzart A, Vermeulin T, et al. Pediatric-like acute lymphoblastic leukemia therapy in adults with lymphoblastic lymphoma: the GRAALL-LYSA LL03 study [published online ahead of print December 7, 2015]. J Clin Oncol. doi: 10.1200/JCO.2015.61.5385.

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