Research Paper Volume 14, Issue 7 pp 3203—3215

Survival and prognostic analysis of T-cell lymphoblastic lymphoma patients treated with dose-adjusted BFM-90 regimen

Hui Yu1, , Lan Mi1, , Fei Qi1, , Xing Wang1, , Yingying Ye1, , Miaomiao Li1, , Dedao Wang1, , Ning Ding1, , Xiaogan Wang1, , Yuqin Song1, , Jun Zhu1, , Yan Xie1, ,

  • 1 Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing, China

Received: January 27, 2022       Accepted: March 28, 2022       Published: April 10, 2022
How to Cite

Copyright: © 2022 Yu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


We aimed to investigate the long-term prognosis and prognostic factors of T-cell lymphoblastic lymphoma (T-LBL) patients who received dose-adjusted Berlin–Frankfurt–Münster (BFM)-90 regimen as first-line therapy in our center. A total of 145 T-LBL patients who underwent first-line dose-adjusted BFM-90 was retrospectively reviewed. Conditional survival analysis was used to evaluate the long-term prognosis of patients. Receiver operating characteristic (ROC) curve was applied to determine the optimal cut-off value for neutrophil-to-lymphocyte ratio (NLR). Estimated 3-year overall survival (OS) and progression-free survival (PFS) rates for overall were 66.8% and 58.4%, respectively. Conditional survival analysis showed that for patients having survived 3 and 5 years or more after the completion of the treatment, the estimated subsequent 3-year OS thereafter increased to 85.7% and 94.3, respectively. Patients receiving consolidation APBSCT (Autologous peripheral blood stem cell transplantation) after BFM-90 regimen had superior 3-year OS than those with non-APBSCT (79.1% vs. 33.4%, p<0.001). We also discovered that baseline NLR ≥4.95 was negatively associated with OS (HR=2.75, 95% CI 1.55-4.89, p=0.015) and PFS (HR=2.07, 95% CI 1.25-4.96, p=0.021) via multivariable analysis. Conclusions: The survival probability of T-LBL patients treated with first-line dose-adjusted BFM-90 has improved significantly as patients have survived for every additional year. The addition of consolidation APBSCT following dose-adjusted BFM-90 therapy bring further survival benefits for those patients. Baseline NLR ≥4.95 was an independent risk factor for T-LBL patients in our study.


BFM-90: Berlin–Frankfurt–Münster 90; T-LBL: T-cell lymphoblastic lymphoma; APBSCT: Autologous peripheral blood stem cell transplantation; OS: Overall survival; PFS: Progression-free survival; ROC: Receiver operating characteristic; NLR: Neutrophil-to-lymphocyte ratio; HR: Hazard ratio; CS: Conditional survival; NHL: Non-Hodgkin lymphoma; BM: Bone marrow; CNS: Central nervous system; T-ALL: T cell acute lymphoblastic leukemia; PR: Partial remission; CR: Complete remission; IPI: International Prognostic Index.