Event-free survival at 24 months (EFS24) appears to be a strong surrogate endpoint in T cell lymphoblastic lymphoma (T-LBL), according to research published in the Annals of Hematology.

While lymphoblastic lymphomas represent a small percentage of non-Hodgkin lymphomas overall, the majority of cases are T-LBL. Optimal treatment for T-LBL has not yet been established and predictive biological markers have not yet been determined.

EFS24 has been established as a strong surrogate marker in other lymphoma subtypes, including diffuse large B cell lymphoma, follicular lymphoma, peripheral T cell lymphoma, and classic Hodgkin lymphoma.

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For this study, researchers evaluated whether EFS24 predicts clinical outcomes in T-LBL, and attempted to enumerate other distinct prognostic factors.

Data from 91 patients were included in the analysis. The median age at diagnosis was 24 years (range, 12-64), 74 (81.3%) patients were men, 81 (89.0%) had an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1, and 86 (94.5%) had central nervous system (CNS) involvement.

The median follow-up was 40.4 months. The 5-year overall survival (OS) rate was 47.9%, while the 5-year EFS rate was 43.2%. Nearly half of patients (45) reached EFS24, while 46 did not. No significant differences were noted between the 2 groups in age, gender, ECOG status, Ann Arbor stage, CNS involvement, or any other baseline factors of interest.

Patients who reached EFS24 had a 5-year OS rate of 90.5% vs 3% among those who did not (P <.001). Other noted prognostic factors after univariate analysis were bone marrow involvement, response to induction treatment, and stem cell transplantation consolidation.

“In conclusion, patients with an achievement of EFS24 have a remarkably superior long-[term] outcome, while patients with early events have an extremely poor outcome,” the authors wrote. “EFS24 is a strong surrogate endpoint for long-term survival in T-LBL, which is clinically useful for individualized risk reassessment, future clinical trial design, and biomarker discovery validation.”


Chen H, Qin Y, Yang J, et al. Event-free survival at 24 months is a robust surrogate endpoint for long-term survival in pediatric, adolescent, and adult T cell lymphoblastic lymphoma. Ann Hematol. Published online July 25, 2020. doi:10.1007/s00277-020-04195-z