Korean J Hematol.  2008 Sep;43(3):138-144. 10.5045/kjh.2008.43.3.138.

VPDL Chemotherapy for T-cell Lymphoblastic Lymphoma (T-LBL) in Adults: Comparison with Upfront Autologous Stem Cell Transplantation in a Single Center

• Yoon DH
• Sohn BS
• Lee WJ
• Lim SN
• Kim EK
• Park I
• Kim KM
• Jang G
• Kim S
• Lee DH
• Huh J
• Suh C

• KMID: 2252179
• DOI: http://doi.org/10.5045/kjh.2008.43.3.138

Abstract

BACKGROUND: Treatment of T-cell lymphoblastic lymphoma (T-LBL) with CHOP or CHOP-like chemotherapy has resulted in poor long-term outcomes. High-dose chemotherapy followed by ASCT has been applied for this dreaded disease. However, the efficacy is still controversial. T-LBL is considered the nodal/extranodal presentation of acute lymphoblastic leukemia. Favorable results with VPDL chemotherapy have been reported in the setting of adult lymphoblastic leukemia. We, therefore, treated T-LBL patients with modified VPDL chemotherapy and compared the outcomes with those achieved using upfront ASCT.
METHODS
We retrospectively reviewed the outcomes of 24 T-LBL patients treated either with upfront ASCT (n=11) or VPDL chemotherapy without ASCT (n=13) between January 1996 and October 2005.
RESULTS
The median follow-up duration for surviving patients was 17 months (range, 5~109 months). The two-year event-free survival (EFS) rates were 83.1% in the VPDL group and 27.3% in the upfront ASCT group (P=0.008). The two-year overall survival (OS) rates were 83.9% in the VPDL group and 27.3% in the upfront ASCT group (P=0.006).
CONCLUSION
This study suggests that VPDL chemotherapy is very effective and may be superior to upfront ASCT in the treatment of T-LBL patients.

Keyword

T-cell lymphoblastic lymphoma; Chemotherapy and autologous stem cell transplantation

MeSH Terms

Adult
Disease-Free Survival
Follow-Up Studies
Humans
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Retrospective Studies
Stem Cell Transplantation
Stem Cells
T-Lymphocytes

Figure

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  Fig. 1 Probability of overall survival in 13 patients treated with VPDL chemotherapy (solid line) and 11 patients with ASCT (dashed line).

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  Fig. 2 Probability of event free survival in 13 patients treated with VPDL chemotherapy (solid line) and 11 patients with ASCT (dashed line).

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