Outcome of Adult Lymphoblastic Lymphoma Patients Treated in the Real Life According to the Gimema LAL1913 Protocol: A Campus ALL Multicenter Study
Year: 2025
Type: article
Study design: Observational Study
Abstract: The introduction of pediatric-inspired chemotherapy protocols for acute lymphoblastic leukemia (ALL) in the setting of adult patients affected by lymphoblastic lymphoma (LL) has improved the results in terms of outcomes. Within the Campus ALL network, we retrospectively collected data on 50 LL-patients from 23 hematology centers in Italy treated according to the GIMEMA LAL1913 protocol, with the aim of confirming the ALL results and of testing the effectiveness of an approach based on higher cumulative doses of the non-myelosuppressive components such as steroids and pegylated asparaginase, in addition to earlier and more intensive central nervous system prophylaxis. After cycle 3 (high dose methotrexate and cytarabine, C3), the cumulative incidence (CI) of PET-based complete response (CR) was of 83% (median time to response from protocol start: 3.7 months; CI95%: 3.1-4.2). With a median follow-up of 27.5 months, the 2-year overall survival (OS), disease free survival (DFS) ed event free survival rates were of 77%, 76% and 69%, respectively. The 2-year CI of relapse was of 26%. Multivariable analysis identified ECOG ≥ 2 as an independent prognostic factor for OS (HR = 3.279; CI95% 1.035-10.389, p = 0.044) and DFS (HR = 13.00, ICI95%: 3.383-57.909, p < 0.001), respectively. No significant impact was observed for pegylated asparaginase dose (reduced and/or omitted versus (vs.) full doses), age (≥ 55 vs. < 55), stage (0-I vs. II-IV), CD1a (negativity vs. other than CD1a negativity), bone marrow involvement (absent vs. ≤ 20%), or allotransplantation. The results of this study show the appropriateness of the LAL1913 protocol for the management of LL patients. Survival outcomes reflect those expected, although this drug combination was never tested before in a real-life setting. Taken together, these results suggest that LAL1913 might be considered as a reference protocol for the frontline treatment of adult LL patients.
Source: Hematological Oncology
DOI: 10.1002/hon.70153
Authors: M. Delia, D. Lazzarotto, S. Imbergamo, F. Mosna, C. Papayannidis, C. Pasciolla, A. Mulè, N. Fracchiolla, M. Leoncin, M. I. Del Principe, M. Fumagalli, M. Olivi, F. Guolo, M. Lunghi, M. De Gobbi, F. Lussana, L. Santoro, L. Aprile, P. Zappasodi, M. Ciccone, F. Giglio, V. P. Gagliardi, M. Dargenio, A. Curti, M. Bonifacio, S. Chiaretti, P. Musto, R. Foà, A. Candoni
Institutions: Azienda Universitaria Ospedaliera Consorziale - Policlinico Bari, Azienda sanitaria universitaria Friuli Centrale, University of Padua, Azienda Ospedale - Università Padova, Ospedale di Bolzano, Istituto di Ematologia di Bologna, Istituto Tumori Bari, Ospedale Vincenzo Cervello, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Ospedale dell' Angelo, University of Rome Tor Vergata, Azienda Ospedaliera San Gerardo, Azienda Ospedaliera Citta' della Salute e della Scienza di Torino, Ospedale Policlinico San Martino, Azienda Ospedaliero Universitaria Maggiore della Carita, Ospedale San Luigi Gonzaga, University of Milan, Ospedale Papa Giovanni XXIII, Azienda Ospedaliera S.Giuseppe Moscati, Policlinico San Matteo Fondazione, Arcispedale Sant'Anna, IRCCS Ospedale San Raffaele, Ospedale Vito Fazzi, Azienda Ospedaliera Universitaria Integrata Verona, Sapienza University of Rome, University of Bari Aldo Moro, Azienda Ospedaliero-Universitaria di Modena
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4416157161