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Retrospective analysis indicated that 4 doses of pegylated-asparaginase (PEG-Asp) prior to SCT were optimal for survival. A PEG-Asp-intensified pediatric-inspired regimen (PDT-ALL-2016) was evaluated in a prospective cohort and a retrospective adult regimen cohort. The prospective cohort showed superior survival, and non-truncated PEG-Asp dosing improved outcomes; high-dose pre-SCT PEG-Asp (4–5 doses) was associated with better survival across analyses.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/intensified-pegylated-asparaginase-in-consolidation-therapy-improved-outcome-of-allogeneic-hematopoietic-stem-cell-transplantation-for-adult-t-cell-acute-lymphoblastic-leukemia/429466/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/intensified-pegylated-asparaginase-in-consolidation-therapy-improved-outcome-of-allogeneic-hematopoietic-stem-cell-transplantation-for-adult-t-cell-acute-lymphoblastic-leukemia/429466.png","ImageObject",300,407,{"name":92,"@type":93},"Aria","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What consolidation strategy was tested for adult T-cell acute lymphoblastic leukemia?","Question",{"text":112,"@type":113},"The study tested a PEG-Asp-intensified pediatric-inspired consolidation approach (PDT-ALL-2016), where SCT is administered after 4 or 5 doses of pegylated-asparaginase prior to transplantation.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How did the prospective PDT-ALL-2016 cohort compare with the retrospective adult regimen cohort?",{"text":117,"@type":113},"The prospective cohort demonstrated superior survival compared with the retrospective adult regimen cohort after PEG-Asp intensification.",{"name":119,"@type":110,"acceptedAnswer":120},"What PEG-Asp dosing level before SCT was associated with improved outcomes?",{"text":121,"@type":113},"High-dose PEG-Asp (4–5 doses) prior to SCT was associated with better survival versus medium (2–3) and low (0–1) dose groups, including subgroup analyses.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},429466,1791293757,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},2336464648322,"https://ap-avatar.wpscdn.com/avatar/2200025388227c56fec?_k=1778556882303663488","Annals of Hematology (2025) 104:6339–6349  \n[https://doi.org/10.1007/s00277-025-06576-8](https://doi.org/10.1007/s00277-025-06576-8)  \nRESEARCH  \nIntensified pegylated-asparaginase in consolidation therapy improved outcome of allogeneic hematopoietic stem cell transplantation for adult T-cell acute lymphoblastic leukemia  \nJunjie Chen1,2,3 · Jia Li1,2 · Zhixiang Wang1,2,3 · Zicong Huang1,2 · Jieping Lin1,2 · Jiawang Ou1,2 · Xiuli Xu1,2 · Bingqing Tang1,2 · Chenhao Ding1,2 · Zihong Cai1,2 · Ren Lin1,2 · Xuan Li1,2 · Qifa Liu1,2 · Hongsheng Zhou1,2,3  \nReceived: 20 February 2025 / Accepted: 13 August 2025 / Published online: 23 December 2025 © The Author(s) 2025  \nAbstract  \nResearch on the optimal consolidation therapy for adult T-cell acute lymphoblastic leukemia (T-ALL) remains limited, and how to integrate pediatric-inspired chemotherapy with allogeneic hematopoietic stem cell transplantation (SCT) is less addressed. Based on retrospective analysis indicating that 4 doses of pegylated-asparaginase (PEG-Asp) prior to SCT were optimal for survival, we designed a PEG-Asp-intensified pediatric-inspired regimen, PDT-ALL-2016, for adult T-ALL (NCT03564704) . In this protocol, SCT administered following 4 or 5 doses of PEG-Asp. The impact of PEG-Asp on transplantation outcomes was evaluated in two cohorts: the prospective PDT-ALL-2016 cohort (2016.1-2021.12, N= 63) and the retrospective adult regimen cohort (2008.1-2015.12, N= 61). With intensified PEG-Asp consolidation, the prospective cohort exhibited superior survival compared to the retrospective cohort. Furthermore, within the prospective cohort, patients who received non-truncated PEG-Asp demonstrated better survival than those who received a truncated dose. Then, the entire cohort was stratified into high-dose (4–5 doses, N= 45), medium-dose (2–3 doses; N= 33) and low-dose (0–1 doses; N= 46) groups, based on the number of PEG-Asp doses administrated pre-SCT. The high-dose group showed superior survival compared to the other two groups in both the entire cohort and in subgroup analysis. Our findings indicate that high-dose PEG-Asp is associated with improved outcome in adult T-ALL undergoing SCT.  \nKeywords T-cell acute lymphoblastic leukemia · Allogeneic hematopoietic stem cell transplantation · Asparaginase · Minimal residual disease  \nIntroduction  \nT cell acute lymphoblastic leukemia (T-ALL) accounts for approximately 20–25% of adult ALL cases [1] . Allogeneichematopoietic stem cell transplantation (SCT) has long  \n􀀍 Hongsheng Zhou [hanson_tcm@126.com](hanson_tcm@126.com)  \n1 Department of Hematology, Nanfang Hospital, Southern Medical University, Rd 1838 Guangzhou Avenue, Guangzhou 510515, China  \n2 Guangdong Provincial Clinical Research Center for Hematologic Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China  \n3 Department of Hematology, Ganzhou People’s Hospital (Nanfang Hospital Ganzhou Hospital), Ganzhou, China  \nbeen considered the cornerstone of treatment for adult ALL when treated with standard adult protocols [1, 2] . However, the introduction of pediatric-inspired regimens has significantly improved survival rates for adult T-ALL [3–7] . Both allogeneic hematopoietic stem cell transplantation and pediatric-inspired chemotherapy regimens can reduce therelapse rate of adult ALL to approximately 40% . Nevertheless, the optimal integration of SCT with pediatric-inspired chemotherapy in T-ALL to further improve survival remains underexplored.  \nDepletion of asparagine by administration of the asparaginase (Asp) has been a critical component of the pediatricinspired regimen [8–10] . We retrospectively observed that post-SCT survival in adult ALL was associated with the cumulative dose of pegylated-asparaginase (PEG-Asp), with 4 doses demonstrating the best survival. Based on this findings, we designed PDT-ALL-2016 pediatric-inspired  \nprotocol (NCT03564704), in which SCT is performed after patients receive four or five doses of PEG-Asp during c","cbCaigwe8ibN8RgJ","https://ap.wps.com/l/cbCaigwe8ibN8RgJ","pdf",1601775,11,"English","# Abstract\n# Introduction\n# Methods\n## Patients and pre-HSCT chemotherapy","[{\"question\":\"What consolidation strategy was tested for adult T-cell acute lymphoblastic leukemia?\",\"answer\":\"The study tested a PEG-Asp-intensified pediatric-inspired consolidation approach (PDT-ALL-2016), where SCT is administered after 4 or 5 doses of pegylated-asparaginase prior to transplantation.\"},{\"question\":\"How did the prospective PDT-ALL-2016 cohort compare with the retrospective adult regimen cohort?\",\"answer\":\"The prospective cohort demonstrated superior survival compared with the retrospective adult regimen cohort after PEG-Asp intensification.\"},{\"question\":\"What PEG-Asp dosing level before SCT was associated with improved outcomes?\",\"answer\":\"High-dose PEG-Asp (4–5 doses) prior to SCT was associated with better survival versus medium (2–3) and low (0–1) dose groups, including subgroup analyses.\"}]","Intensified pegylated-asparaginase in consolidation therapy improved outcome of allogeneic hematopoietic stem cell transplantation for adult T-cell acute lymphoblastic leukemia | PDF",1790650215,28]