目的：分析同种异基因造血干细胞移植（allo-HSCT）治疗T淋巴母细胞白血病/淋巴瘤（T-ALL/LBL）的疗效和预后因素。方法：回顾性评估北京大学第三医院和中国医学科学院血液病医院2006年1月至2020年1月期间的119例T-ALL/LBL青少年和成人患者。根据巩固方案，患者分为化疗组、化疗后allo-HSCT组和化疗后自体造血干细胞移植（auto-HSCT）组，比较各组的5年总生存率（OS）和无进展生存率（PFS）。结果：在113例有效随访患者中，96例（84.9%）患者获得总体反应（ORR），其中79例（69.9%）完全缓解（CR），17例（15.0%）部分缓解（PR），截至2022年7月。对96例ORR患者的分析表明，未进行移植的患者与allo-HSCT组相比，预后较差（5年OS：11.4% vs 55.6%，P=0.001；5年PFS：8.9% vs 54.2%，P<0.001）。allo-HSCT组和auto-HSCT组的5年OS和5年PFS无差异（P=0.271，P=0.197）。CR人群也得到了相同的结果。对于17例PR病例，allo-HSCT较auto-HSCT组在5年OS方面更好（37.5% vs 0，P=0.064）。不同供体来源对5年OS无影响，同胞供体61.1% vs 半相合供体63.6% vs 无关供体50.0%（P>0.05）。早幼稚T细胞前体急性淋巴细胞白血病/淋巴瘤（ETP）和非ETP人群在治疗反应方面无显著差异。化疗组中ETP组5年OS较非ETP组较低（0 vs 12.6%，P=0.045），而allo-HSCT组ETP组与非ETP组间无显著差异（75.0% vs 62.9%，P=0.852）。多因素分析显示高血清乳酸脱氢酶水平、未进行移植和化疗诱导后无CR与不良预后独立相关（P<0.05）。结论：allo-HSCT可能是一种有效的T-ALL/LBL成人和青少年患者巩固治疗方法。不同供体来源对生存率无影响。allo-HSCT可能克服ETP-ALL/LBL对OS的不利影响。

Objective: To analyze the efficacy and prognostic factors of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for treating T lymphoblastic leukemia/lymphoma (T-ALL/LBL) . Methods: This study retrospectively evaluated 119 adolescent and adult patients with T-ALL/LBL from January 2006 to January 2020 at Peking University Third Hospital and Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences. Patients were divided into chemotherapy-only, chemotherapy followed by allo-HSCT, and chemotherapy followed by autologous hematopoietic stem cell transplantation (auto-HSCT) groups according to the consolidation regimen, and the 5-year overall survival (OS) and progression-free survival (PFS) rates of each group were compared. Results: Among 113 patients with effective follow-up, 96 (84.9%) patients achieved overall response (ORR), with 79 (69.9%) having complete response (CR) and 17 (15.0%) having partial response (PR), until July 2022. The analysis of the 96 ORR population revealed that patients without transplantation demonstrated poorer outcomes compared with the allo-HSCT group (5-year OS: 11.4% vs 55.6%, P=0.001; 5-year PFS: 8.9% vs 54.2%, P<0.001). No difference was found in 5-year OS and 5-year PFS between the allo-HSCT and auto-HSCT groups (P=0.271, P=0.197). The same results were achieved in the CR population. Allo-HSCT got better 5-year OS (37.5% vs 0) for the 17 PR cases (P=0.064). Different donor sources did not affect 5-year OS, with sibling of 61.1% vs hap-haploidentical of 63.6% vs unrelated donor of 50.0% (P>0.05). No significant difference was found in the treatment response in the early T-cell precursor acute lymphoblastic leukemia/lymphoma (ETP) and non-ETP populations. The ETP group demonstrated lower 5-year OS compared with the non-ETP group in the chemotherapy alone group (0 vs 12.6%, P=0.045), whereas no significant difference was found between the ETP and non-ETP groups in the allo-HSCT group (75.0% vs 62.9%, P=0.852). Multivariate analysis revealed that high serum lactate dehydrogenase level, without transplantation, and no CR after chemotherapy induction were independently associated with inferior outcomes (P<0.05) . Conclusion: Allo-HSCT could be an effective consolidation therapy for adult and adolescent patients with T-ALL/LBL. Different donor sources did not affect survival. Allo-HSCT may overcome the adverse influence of ETP-ALL/LBL on OS.