IM2 Regimen Is Effective and Safe for Relapsed or Refractory T-Cell Lymphoblastic Lymphoma/Leukemia

Patients with refractory or relapsed (R/R) T-cell lymphoblastic lymphoma/leukemia (T-LBL/ALL) typically exhibit poor responses to salvage chemotherapy, leading to a dismal prognosis. IM2 as a novel salvage regimen for R/R T-LBL/ALL, which is composed of Ifosfamide, liposome Mitoxantrone or Idarubicin, and Methotrexate, was retrospectively assessed for its efficacy and safety. Total 23 patients were enrolled into the study, which included 13 diagnosed as LBL and 10 as ALL. Among the cohort, 78% were male, 48% presented with mediastinum giant mass. Following 1 to 6 cycles of IM2, 7 patients (30.4%) achieved complete remission (CR), 7 (30.4%) achieved partial remission (PR), resulting in a best overall response rate (ORR) of 60.8%. Treatment-related adverse events (AEs) were observed in 91% of patients, with no treatment-related deaths. With a median follow-up time of 7 months (range, 2-50 months), the median OS and PFS of all the patients were 9 months and 5 months, respectively. The estimated 2-year OS and PFS were 39.2% and 37.2%. The median survival for patients achieving CR after IM2 was 24 months (range 6-50 months), with 1-year overall survival (OS) and progression-free survival (PFS) rates of 87.5% and 77.8%, respectively. Multi-variate Cox analysis revealed that allogeneic peripheral blood stem cell transplantation (allo-PBSCT) after IM2 therapy was an independent favorable prognostic factor for OS and PFS. The study suggested that IM2 regimen might be an effective and safe choice for R/R T-LBL/ALL.

No relevant conflicts of interest to declare.