Analysis of the efficacy and safety of the IVD/EM maintenance regimen as post-remission treatment for adult patients with T-cell lymphoblastic lymphoma/leukemia.

OBJECTIVE: To analyze the efficacy and safety of ifosfamide + vincristine + dexamethasone/etoposide + mitoxantrone (IVD/EM) regimen as maintenance therapy in adult patients with T-cell lymphoblastic lymphoma/leukemia (T-LBL/ALL). A total of 53 patients with T-LBL/ALL were enrolled, with a median age of 27 (range, 18-73) years and a male-to-female ratio of 2.5:1. Compared with the transplantation group, the 1‑, 3‑, and 5‑year progression‑free survival (PFS) rates in the alternating maintenance group were 77.8% vs 71.4%, 66.7% vs 64.8% and 58.3% vs 60.7%, respectively; the 1‑, 3‑, and 5‑year overall survival (OS) rates were 94.4% vs 74.3%, 66.2% vs 71.4% and 66.2% vs 71.4%, respectively. No statistically significant differences were observed in PFS and OS rates between the two groups (P = 0.908; P = 0.972). Although the recurrence rate in the maintenance group tended to be higher than that in the transplantation group (P = 0.129), non‑relapse mortality was significantly reduced in the alternating maintenance group (P = 0.046). Multivariate analysis demonstrated that male and elevated β2‑microglobulin levels were independent adverse factors for PFS in patients with T‑LBL/ALL (P < 0.05), while the presence of elevated β2-microglobulin levels at diagnosis was an independent prognostic factor for OS (P < 0.05).

SAFETY: In terms of safety, adverse events in the alternating maintenance group were predominantly grade 1-2, and no treatment-related deaths were observed.

CONCLUSION: The IVD/EM maintenance regimen is safe and effective in post-remission therapy for adult patients with T-LBL/ALL.