Analysis of Prognostic Factors for Survival in 75 Chinese Patients with Peripheral T-Cell Lymphoma (PTCL)

Peripheral T-cell lymphoma (PTCL) is a heterogeneous group of aggressive lymphomas with poor clinical outcomes. The aim of this retrospective study was to correlate the clinical characteristics, risk factors, and treatment methods with overall survial in 75 Chinese patients with PTCL.

Retrospective chart review was conducted to identify patients with newly diagnosed PTCL who were treated at our center from April 2004 to November 2011. Clinical information including demographics, histology, treatment, and survival were collected. Probability of overall survival was estimated using the Kaplan-Meier method. Univariate analysis and log rank test were used to correlate survival with prognostic variables. SPSS1 program (version 7.0) was used for statistic analysis.

A total of 75 patients were identified. The median age was 48 years (range 18–73), and M:F ratio was 2:1. Histologic subtypes included PTCL-not-otherwise specified (PTCL-NOS) (n=37, 49.3%), natural killer/T-cell lymphoma (NK/TCL) (n=25, 33.3%), anaplastic large cell lymphoma (ALCL) (n=11, 14.7%), and angioimmunoblastic T-cell lymphomas (AITL) (n=2, 2.7%). The induction chemotherapy consisted primarily of CHOP (n=49, 65.3%), hyperCVAD (n=12, 75%) and SMILE (n=4, 5.3%). Fifty-nine patients (79%) received chemotherapy alone, while 16 patients (21%) received additional autologous hematopoietic stem cell transplantation (HSCT). Of all the patients, overall survial (OS) at 5-year and 3-year were 41.5% and 64.1%, respectively. The 5-year OS was significantly better (P<0.05) in patients who 1) were less than 60 years (46.8% vs 24.5%, comparing to those older than 60); 2) had normal LDH (74.6% vs 24.2%, comparing to high LDH; 3) had IPI score ≤2 (46.5% vs 22.4%, comparing to IPI score>2); 4) had HSCT (80% vs 30.8%, comparing to those receiving chemothrapy only). OS at 5-year for patients treated with chemotherapy alone was lower with CHOP compared to more intensive regimens (28.7 vs 71.3%, P<0.05). Meanwhile, OS at 5-year was higher in patients treated with etoposide containing chemotherapy (60% vs 27.4%, P<0.05). The 3-year OS was higher (P<0.05) in those with 1) normal β2-microglobulin (92.9% vs 49.3%, comparing to elevated β2-microglobulin), 2) Ki-67<10% (86.2% vs 47%, comparing to Ki-67≥10%), 3) PIT score ≤2 (70% vs 28.6%, comparing to PIT score>2). In addition, failure to achieve complete remission after chemotherapy and bone marrow involvement were correlated to poor survival.

Chinese patients with PTCL have heterogeneous and generally poor outcomes. Bone marrow involvement, older age, elevated LDH, high β2-microglobulin, Ki-67≥10%, IPI >2 and PIT >2 were associated with inferior survival. Intensive chemotherapy and HSCT may improve the long-term survival of PTCL.

No relevant conflicts of interest to declare.