Comparison of Early T-Cell Precursor and Non-ETP Subtypes Among 122 Chinese Adults With Acute Lymphoblastic Leukemia
Yi Zhang, Jiejing Qian, Yile Zhou, Xin Huang, Jianhu Li, Xueying Li, Chenying Li, Huanping Wang, Yinjun Lou, Haitao Meng, Wenjuan Yu, Hongyan Tong, Jie Jin, Hong‐Hu Zhu
Abstract
Background: Adult T-cell acute lymphoblastic leukemia (T-ALL) is a rare hematological malignancy, and significantly linked to poor outcomes. Early T-cell precursor (ETP) leukemia is a unique subtype of T-ALL. The aim of this study is to compare the differences between ETP and non-ETP ALLs in China. Methods: We retrospectively analyzed the records of 122 adult T-ALL patients diagnosed and treated at our center between Jan 2014 and Jun 2019. All the patients enrolled were categorized into ETP and non-ETP ALL by immunophenotype, and further statistical analysis about clinical data and prognostic factors were performed. Results: Among the 122 cases, the male-to-female ratio was 2.8:1, and the median age is 29 (range 16-82) years. Except for 10 patients with insufficient immunophenotyping results, 47.3%(53/112) are ETP and 52.7%(59/112) are non-ETP. Compared with non-ETP patients, ETP-ALL patients had lower WBC counts and LDH levels, while they were older, had higher PLT counts and fibrinogen levels (all p0.05). In the landmark analysis of CR1 patients who had a survival of more than 6 months, allo-SCT group had significantly better survival outcomes than chemotherapy group, and the 2-year OS rates and RFS rates were 80.1±7.3% vs 28.4±8.4%, and 68.9±8.8% vs 12.8±7.2%, respectively (both p<0.0001). Multivariate analysis suggests that allo-SCT acts as an independent prognostic factor for both OS and RFS. Conclusions: Our results revealed that ETP accounted for a high proportion of T-ALL in Chinese. There is no CR rates and prognosis differences between ETP and non-ETP. Allo-SCT in CR1 can significantly improve patients’ survival.