In an abstract presented at the 11th Annual Meeting of the Society of Hematologic Oncology (SOHO), Houston, Texas, researchers from the Dana Farber Cancer Institute, Boston, Massachusetts, and Massachusetts General Hospital, Boston, shared the results of 20 years of allogeneic hematopoietic stem-cell transplantation (allo-HSCT) in patients with T-cell prolymphocytic leukemia (T-PLL).
Data from 35 patients treated with allo-HSCT at either institution from 2002-2022 were collected and analyzed for several outcomes. The median patient age was 61 at the time of transplant.
Most patients underwent only 1 transplant, and none had more than 2. Most (66%) received donor cells from an unrelated matched donor, and 74% had preconditioning with alemtuzumab. Nearly one-third received graft-versus-host disease (GVHD) prophylaxis with methotrexate, sirolimus, and tacrolimus.
At a median follow-up of 60.8 months, 46% and 37% had acute and chronic GVHD, respectively. Most patients with acute GVHD were grade II (56%) and none were grade IV. Chronic GVHD was mild for 69% of patients who developed it, and there were no severe cases.
Median overall survival in this study was 24 months, and the most common cause of death was disease progression.
Regarding mortality rates, the authors noted, “At 72 months, the probability of non-relapse mortality in the patients with vs without GVHD was 0.44 (0.18-0.71) vs 0.7 (0.3-1.11), and the transplant-related mortality (TRM) was 0.19 (0.02-0.37) vs 0.08 (0-0.23).”
These results led the authors to conclude that T-PLL outcomes “remain dismal” despite transplantation and that novel therapies are needed for this rare disease.
Reference
Merrill M, Redd R, Singh S, et al. The Outcomes of Patients With T-Cell Prolymphocytic Leukemia After Allogenic Stem Cell Transplant: A Multicenter Retrospective Study. Abstract TCL-423. Presented at the 11th Annual Meeting of the Society of Hematologic Oncology; September 6-9, 2023; Houston, Texas.
