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Published in: International Journal of Hematology 3/2024

01-02-2024 | T-Lymphoblastic Lymphoma | Original Article

Nelarabine-containing salvage therapy and conditioning regimen in transplants for pediatric T-cell acute lymphoblastic leukemia and lymphoma

Authors: Masato Yanagi, Makiko Mori, Mamoru Honda, Yuichi Mitani, Masafumi Seki, Kohei Fukuoka, Koichi Oshima, Yuki Arakawa, Katsuyoshi Koh

Published in: International Journal of Hematology | Issue 3/2024

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Abstract

Therapy for relapsed or refractory (r/r) T-cell acute lymphoblastic leukemia (T-ALL) and T-cell lymphoblastic lymphoma (T-LBL) in children is challenging, and new treatment methods are needed. We retrospectively analyzed eight patients with r/r T-ALL (five patients) and T-LBL (three patients) who were treated with nelarabine (NEL) plus etoposide, cyclophosphamide, and intrathecal therapy, administered 3 days apart. Five patients achieved a complete response, and the other three achieved a partial response (PR). All patients underwent hematopoietic stem cell transplantation (HSCT) after two cycles of treatment, except for one patient who received one cycle. Three patients who had previously received HSCT were treated with reduced-intensity conditioning regimens, including fludarabine, melphalan, and NEL; one survived for over 5 years after the second HSCT. Grade 2 neuropathy occurred in one patient, but other severe toxicities commonly associated with NEL were not observed during NEL administration in combination with chemotherapy. The 2-year overall survival and event-free survival rates were 60.0% and 36.5%, respectively. The addition of NEL to reinduction chemotherapy was useful in achieving remission and did not lead to excessive toxicity. In addition, a conditioning regimen, including NEL, appeared to be effective in patients who had previously undergone HSCT.
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Metadata
Title
Nelarabine-containing salvage therapy and conditioning regimen in transplants for pediatric T-cell acute lymphoblastic leukemia and lymphoma
Authors
Masato Yanagi
Makiko Mori
Mamoru Honda
Yuichi Mitani
Masafumi Seki
Kohei Fukuoka
Koichi Oshima
Yuki Arakawa
Katsuyoshi Koh
Publication date
01-02-2024
Publisher
Springer Nature Singapore
Published in
International Journal of Hematology / Issue 3/2024
Print ISSN: 0925-5710
Electronic ISSN: 1865-3774
DOI
https://doi.org/10.1007/s12185-023-03701-z

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