Baseline features, major outcomes, and events after first-line therapy in 862 patients participating in the PETAL trial
| . | All patients . | DLBCL∗ . | PMBCL . | FL grade 3† . | Other aNHL‡ . | ALK+ ALCL . | ALK- PTCL§ . | No aNHL‖ . |
|---|---|---|---|---|---|---|---|---|
| Number of patients | 862 (100.0) | 623 (72.3) | 42 (4.9) | 54 (6.3) | 43 (5.0) | 21 (2.4) | 55 (6.4) | 24 (2.7) |
| Baseline features at study inclusion | ||||||||
| Age, y (range) | 60 (18-80) | 62 (18-80) | 35 (18-80) | 58 (29-80) | 61 (28-76) | 33 (19-66) | 65 (26-79) | 62 (21-79) |
| International Prognostic Index risk group¶ | ||||||||
| Low | 329 (38.3) | 228 (36.7) | 25 (59.5) | 26 (48.2) | 9 (20.9) | 16 (76.2) | 18 (32.7) | 7 (31.8) |
| Low-intermediate | 224 (26.1) | 163 (26.3) | 9 (21.4) | 14 (25.9) | 10 (23.3) | 5 (23.8) | 15 (27.3) | 8 (36.4) |
| High-intermediate | 180 (21.0) | 130 (20.9) | 5 (11.9) | 10 (18.5) | 17 (39.5) | 0 (0.0) | 15 (27.3) | 3 (13.6) |
| High | 125 (14.6) | 100 (16.1) | 3 (7.2) | 4 (7.4) | 7 (16.3) | 0 (0.0) | 7 (12.7) | 4 (18.2) |
| Major outcomes | ||||||||
| Survival rate at 5 y after iPET evaluation# | ||||||||
| Progression-free survival | 66.9 (63.8-70.0) | 67.5 (63.8-71.2) | 90.4 (81.4-99.4) | 79.4 (68.6-90.2) | 67.4 (53.5-81.3) | 75.9 (57.5-94.3) | 32.3 (19.8-44.8) | 53.6 (33.4-73.8) |
| OS | 75.6 (72.7-78.5) | 75.8 (72.5-79.1) | 97.6 (92.9-102.3) | 88.6 (80.0-97.2) | 76.7 (64.2-89.2) | 90.5 (78.0-103.0) | 39.8 (26.9-52.7) | 70.0 (51.4-88.6) |
| Survival rate at 10 y after iPET evaluation# | ||||||||
| Progression-free survival | 57.0 (53.5-60.5) | 58.1 (54.0-62.2) | 84.9 (73.7-96.1) | 61.5 (47.0-76.0) | 56.3 (40.8-71.8) | 75.9 (57.5-94.3) | 21.7 (9.5-33.9) | 32.5 (11.9-53.1) |
| OS | 66.0 (62.7-69.3) | 65.5 (61.4-69.6) | 92.0 (83.4-100.6) | 79.4 (67.8-91.0) | 68.1 (53.6-82.6) | 90.5 (78.0-103.0) | 26.0 (12.9-39.1) | 65.3 (45.7-84.9) |
| Events after first-line therapy | ||||||||
| Progression or relapse | 240 (27.8) | 158 (25.4) | 4 (9.5) | 16 (29.6) | 14 (32.6) | 5 (23.8) | 31 (56.4) | 12 (50.0) |
| Time to first relapse, y (range) | 0.8 (0.0-14.1) | 0.8 (0.0-14.1) | 0.3 (0.2-2.5) | 3.0 (0.6-12.2) | 0.8 (0.2-7.7) | 0.2 (0.1-2.2) | 0.5 (0.0-8.3) | 1.6 (0.3-9.5) |
| Type of salvage therapy∗∗ | ||||||||
| Supportive care alone | 16 (6.7) | 12 (7.6) | 0 (0.0) | 1 (6.3) | 0 (0.0) | 1 (20.0) | 1 (3.2) | 1 (8.3) |
| Chemotherapy, immunotherapy, and/or radiotherapy | 127 (52.9) | 79 (50.0) | 1 (25.0) | 8 (50.0) | 9 (64.3) | 1 (20.0) | 20 (64.5) | 9 (75.0) |
| Auto-SCT | 69 (28.7) | 53 (33.5) | 0 (0.0) | 5 (31.3) | 3 (21.4) | 1 (20.0) | 6 (19.4) | 1 (8.3) |
| Auto-SCT | 28 (11.7) | 14 (8.9) | 3 (75.0) | 2 (12.5) | 2 (14.3) | 2 (40.0) | 4 (12.9) | 1 (8.3) |
| Survival rate at 5 y after first relapse†† | ||||||||
| Progression-free survival | 25.3 (19.6-31.0) | 27.6 (20.3-34.9) | ≤25.0‡‡ (−17.5 to 67.5) | 34.3 (9.4-59.2) | 21.4 (−0.2 to 43.0) | 20.0 (−15.1 to 55.1) | 6.5 (−2.1 to 15.1) | 38.1 (9.3-66.9) |
| OS | 33.5 (27.4-39.6) | 33.1 (25.5-40.7) | 75.0 (32.5-117.5) | 48.1 (23.0-73.2) | 35.7 (10.6-60.8) | 60.0 (17.1-102.9) | 9.7 (−0.7 to 20.1) | 54.7 (24.5-84.9) |
| Second primary malignancies and deaths | ||||||||
| Second primary malignancy | 100 (11.6) | 72 (11.6) | 3 (7.1) | 6 (11.1) | 6 (14.0) | 2 (9.5) | 7 (12.7) | 4 (16.7) |
| Time to second primary malignancy, y (range) | 4.7 (0.3-13.3) | 4.9 (0.3-13.3) | 9.1 (4.9-9.6) | 2.9 (0.4-4.0) | 5.0 (3.0-8.3) | 3.7 (2.8-4.5) | 3.7 (1.5-8.1) | 3.0 (2.3-11.3) |
| Death | 286 (33.2) | 206 (33.1) | 3 (7.1) | 12 (22.2) | 15 (34.9) | 3 (14.3) | 39 (70.9) | 8 (33.3) |
| . | All patients . | DLBCL∗ . | PMBCL . | FL grade 3† . | Other aNHL‡ . | ALK+ ALCL . | ALK- PTCL§ . | No aNHL‖ . |
|---|---|---|---|---|---|---|---|---|
| Number of patients | 862 (100.0) | 623 (72.3) | 42 (4.9) | 54 (6.3) | 43 (5.0) | 21 (2.4) | 55 (6.4) | 24 (2.7) |
| Baseline features at study inclusion | ||||||||
| Age, y (range) | 60 (18-80) | 62 (18-80) | 35 (18-80) | 58 (29-80) | 61 (28-76) | 33 (19-66) | 65 (26-79) | 62 (21-79) |
| International Prognostic Index risk group¶ | ||||||||
| Low | 329 (38.3) | 228 (36.7) | 25 (59.5) | 26 (48.2) | 9 (20.9) | 16 (76.2) | 18 (32.7) | 7 (31.8) |
| Low-intermediate | 224 (26.1) | 163 (26.3) | 9 (21.4) | 14 (25.9) | 10 (23.3) | 5 (23.8) | 15 (27.3) | 8 (36.4) |
| High-intermediate | 180 (21.0) | 130 (20.9) | 5 (11.9) | 10 (18.5) | 17 (39.5) | 0 (0.0) | 15 (27.3) | 3 (13.6) |
| High | 125 (14.6) | 100 (16.1) | 3 (7.2) | 4 (7.4) | 7 (16.3) | 0 (0.0) | 7 (12.7) | 4 (18.2) |
| Major outcomes | ||||||||
| Survival rate at 5 y after iPET evaluation# | ||||||||
| Progression-free survival | 66.9 (63.8-70.0) | 67.5 (63.8-71.2) | 90.4 (81.4-99.4) | 79.4 (68.6-90.2) | 67.4 (53.5-81.3) | 75.9 (57.5-94.3) | 32.3 (19.8-44.8) | 53.6 (33.4-73.8) |
| OS | 75.6 (72.7-78.5) | 75.8 (72.5-79.1) | 97.6 (92.9-102.3) | 88.6 (80.0-97.2) | 76.7 (64.2-89.2) | 90.5 (78.0-103.0) | 39.8 (26.9-52.7) | 70.0 (51.4-88.6) |
| Survival rate at 10 y after iPET evaluation# | ||||||||
| Progression-free survival | 57.0 (53.5-60.5) | 58.1 (54.0-62.2) | 84.9 (73.7-96.1) | 61.5 (47.0-76.0) | 56.3 (40.8-71.8) | 75.9 (57.5-94.3) | 21.7 (9.5-33.9) | 32.5 (11.9-53.1) |
| OS | 66.0 (62.7-69.3) | 65.5 (61.4-69.6) | 92.0 (83.4-100.6) | 79.4 (67.8-91.0) | 68.1 (53.6-82.6) | 90.5 (78.0-103.0) | 26.0 (12.9-39.1) | 65.3 (45.7-84.9) |
| Events after first-line therapy | ||||||||
| Progression or relapse | 240 (27.8) | 158 (25.4) | 4 (9.5) | 16 (29.6) | 14 (32.6) | 5 (23.8) | 31 (56.4) | 12 (50.0) |
| Time to first relapse, y (range) | 0.8 (0.0-14.1) | 0.8 (0.0-14.1) | 0.3 (0.2-2.5) | 3.0 (0.6-12.2) | 0.8 (0.2-7.7) | 0.2 (0.1-2.2) | 0.5 (0.0-8.3) | 1.6 (0.3-9.5) |
| Type of salvage therapy∗∗ | ||||||||
| Supportive care alone | 16 (6.7) | 12 (7.6) | 0 (0.0) | 1 (6.3) | 0 (0.0) | 1 (20.0) | 1 (3.2) | 1 (8.3) |
| Chemotherapy, immunotherapy, and/or radiotherapy | 127 (52.9) | 79 (50.0) | 1 (25.0) | 8 (50.0) | 9 (64.3) | 1 (20.0) | 20 (64.5) | 9 (75.0) |
| Auto-SCT | 69 (28.7) | 53 (33.5) | 0 (0.0) | 5 (31.3) | 3 (21.4) | 1 (20.0) | 6 (19.4) | 1 (8.3) |
| Auto-SCT | 28 (11.7) | 14 (8.9) | 3 (75.0) | 2 (12.5) | 2 (14.3) | 2 (40.0) | 4 (12.9) | 1 (8.3) |
| Survival rate at 5 y after first relapse†† | ||||||||
| Progression-free survival | 25.3 (19.6-31.0) | 27.6 (20.3-34.9) | ≤25.0‡‡ (−17.5 to 67.5) | 34.3 (9.4-59.2) | 21.4 (−0.2 to 43.0) | 20.0 (−15.1 to 55.1) | 6.5 (−2.1 to 15.1) | 38.1 (9.3-66.9) |
| OS | 33.5 (27.4-39.6) | 33.1 (25.5-40.7) | 75.0 (32.5-117.5) | 48.1 (23.0-73.2) | 35.7 (10.6-60.8) | 60.0 (17.1-102.9) | 9.7 (−0.7 to 20.1) | 54.7 (24.5-84.9) |
| Second primary malignancies and deaths | ||||||||
| Second primary malignancy | 100 (11.6) | 72 (11.6) | 3 (7.1) | 6 (11.1) | 6 (14.0) | 2 (9.5) | 7 (12.7) | 4 (16.7) |
| Time to second primary malignancy, y (range) | 4.7 (0.3-13.3) | 4.9 (0.3-13.3) | 9.1 (4.9-9.6) | 2.9 (0.4-4.0) | 5.0 (3.0-8.3) | 3.7 (2.8-4.5) | 3.7 (1.5-8.1) | 3.0 (2.3-11.3) |
| Death | 286 (33.2) | 206 (33.1) | 3 (7.1) | 12 (22.2) | 15 (34.9) | 3 (14.3) | 39 (70.9) | 8 (33.3) |
Numbers are given as n (%) unless otherwise noted.
aNHL, aggressive non-Hodgkin lymphoma; FL, follicular lymphoma; PMBCL, primary mediastinal B-cell lymphoma; PTCL, peripheral T-cell lymphoma.
Including 574 DLBCL and 49 DLBCL combined with FL (n = 43), marginal zone lymphoma (n = 5), or lymphoid granulomatosis grade 2 (n = 1). Because DLBCL alone and DLBCL combined with an indolent lymphoma had similar relapse rates, progression-free survival, and OS (supplemental Figure 1), the 2 groups were combined.
Including 25 FL grade 3a, 17 FL grade 3b, and 12 FL grade 3 combined with grade 1 or 2. Because the 3 groups had similar relapse rates, progression-free survival, and OS (supplemental Figure 1), they were combined.
Including 4 B-cell lymphomas with features intermediate between DLBCL and Burkitt lymphoma, 3 B-cell lymphomas with features intermediate between DLBCL and Hodgkin lymphoma, 2 plasmablastic lymphomas, and 34 unclassified large B-cell lymphomas.
Including 13 ALK− ALCL, 18 angioimmunoblastic T-cell lymphomas, 20 PTCL not otherwise specified, and 4 unclassified PTCL. Because the 4 groups had similar relapse rates, progression-free survival, and OS (supplemental Figure 1), they were combined.
Including 10 FL grade 1 or 2, 7 marginal zone lymphomas, 1 unclassified indolent B-cell lymphoma, 2 mantle cell lymphomas, 2 Burkitt lymphomas, 1 Hodgkin lymphoma, and 1 breast cancer.
Percentages refer to patients with documented data only.
Kaplan-Meier estimate of the percentage of patients surviving after 5 or 10 years, respectively (95% CI). After undergoing first-line immunochemotherapy as specified in the study protocol, 23 patients received consolidating radiotherapy. This was counted as a treatment-failure event in the event-free survival analysis but not in the progression-free survival or OS analyses (Figure 3).
The type of salvage therapy was defined on the basis of the entire disease course (up to 7 lines of salvage therapy), including (1) supportive care alone; (2) chemotherapy, immunotherapy, and/or radiotherapy with or without supportive care, but without transplantation; (3) high-dose chemotherapy with auto-SCT with or without chemotherapy, immunotherapy, radiotherapy, or supportive care, but without allogeneic transplantation; and (4) allogeneic transplantation with or without autologous transplantation, chemotherapy, immunotherapy, radiotherapy, or supportive care.
Kaplan-Meier estimate of the percentage of patients surviving after 5 years (95% CI).
Indicated time point not yet reached, that is, estimate for an earlier time point.