Prognostic value of <scp>PET</scp>/<scp>CT</scp> and <scp>CT</scp> in T‐cell lymphoblastic lymphoma/leukaemia patients: A retrospective cohort study of 145 patients

Rouzaud, Camille; Vercellino, Laëtitia; Kerviler, É. de; Raffoux, Emmanuel; Balsat, Marie; Marçais, Ambroise; Dourthe, M-E; Meignin, Véronique; Asnafi, Vahid; Macintyre, Elizabeth; Boissel, Nicolas; Lengliné, Étienne

doi:10.1111/bjh.18707

Cited by 1 publication

(2 citation statements)

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“…Accordingly, the evaluation of treatment response in T‐LBL might not be as stringent as in T‐ALL, and patients with T‐LBL who had suboptimal treatment response might continue to be included in the first‐line protocol without any intensification and would experience relapse subsequently, with or without L‐asparaginase discontinuation. Meanwhile, a recent study investigating the utility of fluoro‐deoxy‐glucose positron emission tomography (PET‐CT) showed a significant positive correlation between minimal residual disease and patient outcomes among those with ALL and LBL 29 . Identifying patients with early suboptimal treatment responses using a more refined method such as PET‐CT 30 might be critically needed for those with T‐LBL, but this should be evaluated in a prospective clinical trial.…”

Section: Discussionmentioning

confidence: 99%

“…Meanwhile, a recent study investigating the utility of fluoro‐deoxy‐glucose positron emission tomography (PET‐CT) showed a significant positive correlation between minimal residual disease and patient outcomes among those with ALL and LBL. 29 Identifying patients with early suboptimal treatment responses using a more refined method such as PET‐CT 30 might be critically needed for those with T‐LBL, but this should be evaluated in a prospective clinical trial.…”

Section: Discussionmentioning

confidence: 99%

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Differential impact of asparaginase discontinuation on outcomes of children with T‐cell acute lymphoblastic leukemia and T‐cell lymphoblastic lymphoma

Ishida,

Imamura,

Kobayashi

et al. 2024

Cancer Medicine

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BackgroundAsparaginase is essential for treating T‐cell acute lymphoblastic leukemia (T‐ALL). Despite the ongoing debate on whether T‐ALL and T‐cell lymphoblastic lymphoma (T‐LBL) are the same disease entity or two distinct diseases, patients with T‐LBL often receive the same or similar treatment protocols as those with T‐ALL.MethodsThe outcomes of patients with or without L‐asparaginase discontinuation were retrospectively analyzed among four national protocols: Japan Association of Childhood Leukemia Study (JACLS) ALL‐02 and ALL‐97 for T‐ALL and Japanese Pediatric Leukemia/Lymphoma Study Group ALB‐NHL03 and JACLS NHL‐98 for T‐LBL. The hazard ratio (HR) was calculated with the Cox regression model by considering L‐asparaginase discontinuation as a time‐dependent variable.ResultsIn total, 199 patients with T‐ALL, and 133 patients with T‐LBL were included. L‐asparaginase discontinuation compromised event‐free survival (EFS) of T‐ALL patients (ALL‐02: HR 3.32, 95% confidence interval [CI] 1.40–7.90; ALL‐97: HR 3.39, 95%CI 1.19–9.67). Conversely, EFS compromise was not detected among T‐LBL patients (ALB‐NHL03: HR 1.39, 95%CI 0.41–4.68; NHL‐98: HR 0.92, 95%CI 0.11–7.60).ConclusionThe effects of L‐asparaginase discontinuation differed between T‐ALL and T‐LBL. We assume that the differential impact results from (1) the inherent differential response to L‐asparaginase between them and/or (2) a less stringent assessment of early treatment response in T‐LBL than in T‐ALL. Given the poor salvage rate of refractory or relapsed T‐ALL and T‐LBL, optimization of the frontline therapy is critical, and the current study provides a new suggestion for further treatment modifications. However, larger studies in contemporary intensified treatment protocols are required.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%