Efficacy evaluation of the 2017 protocol by the China Net Childhood Lymphoma in treating early T cell precursors-lymphoblastic lymphoma in pediatric patients

• This study retrospectively analyzed the clinical characteristics and treatment outcomes of pediatric ETP-LBL treated by the China Net Childhood Lymphoma (CNCL) from May 2017 to August 2023, aiming to improve understanding of this subtype, enhance treatment strategies, and optimize prognosis. • Over half of pediatric ETP-LBL patients underwent HSCT, yet survival outcomes were comparable to chemotherapy alone. Further studies are needed to validate whether intensive chemotherapy or novel targeted therapies can reduce reliance on HSCT. To analyze the clinical features of early T-cell precursor acute lymphoblastic leukemia/lymphoma (ETP-ALL/LBL) in pediatric patients and to summarize the efficacy evaluation of the 2017 protocol by the China Net Childhood Lymphoma (CNCL) Non-Hodgkin Lymphoma (NHL) 2017-LBL for ETP-LBL. Methods Clinical data of 19 children with ETP-LBL admitted to CNCL from May 2017 to August 2023 were retrospectively collected. Results The median age of onset was 10 years (4.5-13 years), including 16 males (84.2%). All patients were in stage IV and were treated with high-risk chemotherapy regimen. 11 of them (57.9%) underwent hematopoietic stem cell transplantation (HSCT). The proportion of leukemia stage in the HSCT group was significantly higher than that in the chemotherapy group (72.7% vs. 25.0%), and the central nervous system (CNS) status was CNS2/3 in the HSCT group (100% vs. 50%).The 3-year overall survival (OS) and event free survival (EFS) were (93.8±0.61) % and (88.2±0.78) %, respectively. Conclusion Over 50% of pediatric ETP-LBL patients received HSCT, with their long-term survival rates comparable to the chemotherapy group.