Characteristics and therapeutic approaches for patients diagnosed with T-ALL/LBL exhibiting t(8;14)(q24;q11)/TCRA/D:MYC translocation

Abstract

T-acute lymphoblastic leukemia/lymphoma (T-ALL/LBL) patients with t(8;14)(q24;q11)/TCRA/D::MYC translocation represent a rare subgroup, with an aggressive course. In our retrospective analysis of 14 patients, all were identified during refractory or relapsed stages (5 primary tumor, 9 relapse). Notably, extramedullary invasion was detected in most patients. Four exhibited STIL::TAL1 translocation, and six demonstrated CDKN2A/B gene loss. The therapeutic outcomes were notably poor for all seven patients who received only chemotherapy or allogeneic hematopoietic stem cell transplantation (HSCT); all eventually succumbed to the disease with a median OS of 3 months. In the application of CD7 CAR-T therapy in six patients, five achieved CR. Of the four patients who underwent HSCT following CAR-T therapy, all have remained disease-free. The prognosis for T-ALL/LBL patients with t(8;14) translocation remains bleak, but interventions involving CD7 CAR-T may offer a potential pathway to CR. HSCT following CAR-T could be a viable strategy for long-term survival.

Keywords:

• T-all/lbl
• t(8;14)(q24;q11) translocation
• TCRA/D::MYC translocation
• cd7 car-t

Acknowledgements

The authors thank all the medical staff in Hebei Yanda Lu Daopei Hospital for their clinical and technical assistance, especially their care for patients; and Hebei Senlang Biotechnology Co., Ltd for their providing CD7 CAR-T products.

Author contributions

X.Z. and RJ.S, ZJ.W and GL.Z, WQ.L, XN.H conducted the clinical study and provided patient care; T.W and others provided laboratory testing, of which T.W, JB.N, HW.Z, S.H provided chromosome and FISH work, Y.Z, F.W, JQ.C provided gene screening, X.Z, T.W. collected and analyzed data and wrote the manuscript; PH.L, JJ.L revised the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.