Novel Therapies Urgently Needed to Treat Early T-cell Precursor Acute Leukemia, Lymphoma

Adults with early T-cell precursor acute lymphoblastic leukemia/lymphoma (ETP-ALL/LBL), a high risk subset, are in critical need of novel therapies.¹ 

ETP-ALL/LBL was only recently identified as a high-risk subgroup and optimal therapeutic approaches have not yet been clarified.

A study compared the outcomes of adults with ETP-ALL/LBL who received treatment with frontline therapies with patients who were diagnosed with other T-ALL/LBL immunophenotypic subtypes and found lower complete remission rates and overall survival in this patient population.

A total of 111 patients with T-ALL/LBL (68% T-ALL; 32% T-LBL) who received frontline chemotherapy at The University of Texas MD Anderson Cancer Center between 2000 and 2014 were identified for the study.

They were immunophenotypically categorized into early, thymic, and mature according to the World Health Organization (WHO) classification using CD1a and sCD3 status. Patients with ETP-ALL/LBL were identified on the following immunophenotype: CD1a(-), CD8(-), CD5(-/dim), and positivity for one of more stem cell myeloid antigens.

A total of 19 patients diagnosed with ETP-ALL/LBL were included in the study. Results showed that there was no difference in outcomes based on WHO classification.

Those with EPT-ALL/LBL had significantly lower complete remission rate with incomplete platelet recovery rate when compared with patients with non-ETP-ALL/LBL (73% vs 91%; P = .03). Median overall survival for those with ETP-ALL/LBL was 20 months vs not reached for the non-ETP-ALL LBL patients.

Reference

1. Jain N, Lamb AE, O’Brien, S, et al. Early T-cell precursor acute lymphoblastic leukemia/lymphoma (ETP-ALL/LBL) in adolescents and adults: a high-risk subtype [published online ahead of print January 8, 2016]. Blood. doi: 10.1182/blood-2015-08-661702.