复发/难治性皮质（CD1a⁺）T 细胞急性淋巴细胞白血病儿童与成人患者的结局：SEHOP 与 PETHEMA 协作组的西班牙经验

Patients with relapsed/refractory T-cell acute lymphoblastic leukemia (R/R T-ALL) have very poor prognosis. CAR T-cell therapy is being explored in these patients with encouraging results. Specifically, CD1a-directed CAR T-cells are being explored in clinical trials to treat cortical T-ALL (CD1a+), but there are no data on outcome in this subgroup of patients before this therapy. This retrospective, observational study aimed to describe the characteristics and outcomes of patients with R/R CD1a + T-ALL.

We included pediatric and adult patients diagnosed with R/R CD1a + T-ALL in 25 sites of Spain between March 2006 and May 2022. The primary outcome of the study was overall survival (OS). Forty-three patients, 28 adults and 15 children, with R/R CD1a + T-ALL were included. Median (range) age at inclusion was 24 years (5 57), and 82. 5% were male.

After a median (range) follow-up of 7. 0 years (5. 1 13. 6), 6 (14. 0%) patients were alive and in complete remission (CR) and 37 (86. 0%) had died. Five-year OS was 16% (95% CI; 7 29%). Bone marrow relapse, an interval < 12 months between first CR and relapse, and lack of allogeneic hematopoietic stem cell transplantation during salvage treatment were associated with worse OS.

Our results confirm that patients with R/R CD1a + T-ALL have a very poor prognosis, highlighting the need for new treatment alternatives in these patients.