ASH 2025 Research Results: Survival Outcomes In Young People with Relapsed T-Cell Acute Lymphoblastic Leukemia (T-ALL) and T-Cell Lymphoblastic Lymphoma (T-LL)

Over the last 20 years, progress in increasing survival outcomes for children, adolescents, and young adults with relapsed or refractory T-cell acute lymphoblastic leukemia and T-cell lymphoblastic lymphoma, has been relatively slow.

Chemotherapy resistance and treatment-related mortality are two major barriers to survival.  Because of a lack of research conducted in this area, the impact of these factors on survival is not immediately clear.  To better understand outcomes among young people with T-ALL and T-LL, a recent study gathered data on rates of complete remission following treatment, the frequency of treatment-related mortality, the number of patients who proceed to stem cell transplant, and survival. 

The Study

The study enrolled 112 patients who were under the age of 21 at the time they were diagnosed.  

Of the participants enrolled:

• 93 had T-ALL, and 19 had T-LL  

• 99 study participants were in first relapse

• 81 with T-All  and 18 with T-LL

• Eight had primary refractory disease

Rates of remission highlight potential differences in treatment responses. 

Complete remission occurs when signs of disease are no longer detectable. The study found that rates of complete remission were higher in participants with T-ALL (70%) compared to those with T-LL (50%). Most patients with T-ALL who were in first relapse or had refractory disease achieved remission after just one cycle of treatment, while patients with T-LL typically required two cycles to reach remission. 

Additional research is needed to better understand treatment-related mortality in T-ALL and T-LL. 

Treatment-related mortality, or death related to the treatment, remains a serious concern for children, adolescents, and young adults undergoing an intensive treatment like this one. In the study, 20% of all patient deaths were caused by complications related to treatment rather than the disease itself.  There was a trend showing higher rates of TRM in T-ALL patients.  However, it is unclear whether T-ALL patients truly have a higher risk of TRM or if the numbers varied because of other factors.

About half of the study participants moved on to stem cell transplant.

Stem cell transplant is an important step in treatment for many patients with relapsed or refractory T-ALL and T-LL, offering a potential path to long-term remission. 52% of participants with T-ALL and 47% of participants with T-LL moved forward to stem cell transplant between 3 and 4 months after the study began. Ongoing research is essential to better understanding the slightly higher transplant rate among T-ALL patients compared to those with T-LL. 

Low survival rates in this study highlight the need for additional research.

The three-year overall survival was 41% for patients with T-ALL and 21% for those with T-LL. Similarly, event-free survival, or the time patients remained free from relapse or serious complications, was 39% for T-ALL and 21% for T-LL.  

While rates of survival tended to be higher for those with T-ALL than T-LL, there could be other things that contributed to these outcomes.  More research with larger patient groups is needed to better understand factors that influence survival and treatment-related risks among these patient groups. 

Conclusion

This study provides important information about the present opportunities to improve outcomes in young patients with T-ALL and T-LL.  These findings highlight key areas to focus on to improve treatment strategies and increase the number of patients who move forward to transplant and achieve lasting remission. 

To continue reading about recent studies like this, check out HealthTree’s News at the link below. 

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Source: 

https://ash.confex.com/ash/2024/webprogram/Paper209138.html